title: Diagnostic variability of laryngeal premalignant lesions: histological evaluation and carcinoma transformation.
abstract: OBJECTIVE
  This study was to analyze the interobserver histopathological variability and carcinoma transformation of laryngeal premalignant lesions.
  
  
  METHODS
  A historical cohort study.
  
  
  METHODS
  Department of Pathology, Beijing TongRen Hospital, Capital Medical University, Beijing, China.
  
  
  METHODS
  κ-statistics analysis was performed to estimate interobserver histopathological variability among pathologists by reassessment of 237 cases with laryngeal premalignant lesion according to 2005 WHO classification system. A retrospective follow-up of 237 patients over 8-year duration was carried out, and the carcinoma transformation of laryngeal premalignant lesions was analyzed using Kaplan-Meier survival curve estimation.
  
  
  RESULTS
  κ-values of 0.5989 concerning interobserver variability indicated a moderate agreement among 3 pathologists. Major source of intergrade diagnostic disagreement between the original and the consensus diagnoses involved 2 grade pairs, namely, mild and moderate dysplasia, severe dysplasia, and carcinoma in situ. In addition, follow-up study showed that 20 of 237 (8.44%) laryngeal premalignant lesion cases developed into invasive carcinoma. Carcinoma transformation in severe dysplasia group exhibited a similar risk compared to that in carcinoma in situ group (P = .232).
  
  
  CONCLUSIONS
  Severe dysplasia shows the same carcinoma transformation potential as the carcinoma in situ does. Clinically, more attention to severe dysplasia is needed in comparison with mild and moderate dysplasia.
authors.affiliation: Department of Pathology, Beijing TongRen Hospital, Capital Medical University, Beijing, China.
authors.forename: Yanping
authors.initials: Y
authors.lastname: Hu
authors.forename: Honggang
authors.initials: H
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002471:Cell Transformation, Neoplastic / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000473:pathology*; D015203:Reproducibility of Results; D055815:Young Adult
keywords: carcinoma transformation; histology; larynx; premalignant lesion; prognosis