ABSTRACT:
Objective : To propose a scoring system based on laryngoscopic
characteristics for the differential diagnosis of benign and malignant
vocal cord leukoplakia.
Design: Retrospective study.
Setting: Tertiary hospitals
Participants: Laryngoscopic images from 200 cases of vocal cord
leukoplakia were retrospectively analyzed. The morphologies of vocal
cord leukoplakia under laryngoscopy were evaluated by two
laryngologists.
Main outcome measures: The laryngoscopic signs of benign and
malignant vocal cord leukoplakia were compared, and statistically
significant features were assigned and accumulated to establish the
leukoplakia finding score (LFS).
Results : A total of five indicators (size, thickness, texture,
hyperemia, and anterior commissure involvement) associated with
malignant vocal cord leukoplakia were included to construct the LFS,
with a possible range of 0–10 points. The diagnosis of malignant vocal
cord leukoplakia as a score of ≥6 points was the most efficient. The
sensitivity, specificity, and accuracy of the LFS were 93.8%, 83.6%,
and 86.0%, respectively. The consistency in the LFS obtained by
different laryngologists was strong (kappa=0.809).
Conclusion : This scoring system based on laryngoscopic
characteristics has high diagnostic value for distinguishing benign and
malignant vocal cord leukoplakia.
Key Words: Laryngoscopy, diagnosis, vocal cord leukoplakia,
scoring