European Laryngological Society position paper on laryngeal dysplasia Part I : aetiology and pathological classification
Odell, Edward (King's College Hospital NHS Foundation Trust)
Eckel, Hans Edmund (Klagenfurt General Hospital)
Simo, Ricard (Guy's and St Thomas' NHS Foundation Trust (Regne Unit))
Quer, Miquel (Institut d'Investigació Biomèdica Sant Pau)
Paleri, Vinidh (Royal Marsden Hospital (Regne Unit))
Klussmann, Jens Peter (Uniklinik Köln (Colònia, Alemanya))
Remacle, Marc (Department of Otorhinolaryngology, Head and Neck Surgery, CH Luxembourg, Luxembourg, Belgium)
Sjögren, Elisabeth (Leiden University Medical Center)
Piazza, Cesare (ASST Spedali Civili of Brescia, University of Brescia)
Universitat Autònoma de Barcelona

Date:	2020
Abstract:	To give an overview of the current knowledge regarding the aetiology, epidemiology, and classification of laryngeal dysplasia (LD) and to highlight the contributions of recent literature. As most cases of dysplasia occur at the glottic level and data on diagnosis and management are almost exclusively from this location, laryngeal dysplasia in this position paper is taken to be synonymous with dysplasia of the vocal folds. LD has long been recognized as a precursor lesion to laryngeal squamous cell carcinoma (SCC). Tobacco and alcohol consumption are the two single most important etiological factors for the development of LD. There is currently insufficient evidence to support a role of reflux. Although varying levels of human papillomavirus have been identified in LD, its causal role is still uncertain, and there are data suggesting that it may be limited. Dysplasia has a varying presentation including leukoplakia, erythroleukoplakia, mucosal reddening or thickening with exophytic, "tumor-like" alterations. About 50% of leukoplakic lesions will contain some form of dysplasia. It has become clear that the traditionally accepted molecular pathways to cancer, involving accumulated mutations in a specific order, do not apply to LD. Although the molecular nature of the progression of LD to SCC is still unclear, it can be concluded that the risk of malignant transformation does rise with increasing grade of dysplasia, but not predictably so. Consequently, grading systems are inherently troubled by the weak correlation between the degree of the dysplasia and the risk of malignant transformation. The best data on LD grading and outcomes come from the Ljubljana group, forming the basis for the World Health Organization classification published in 2017.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article de revisió ; Article ; Versió publicada
Subject:	Carcinoma in situ ; Dysplasia ; Laryngeal intraepithelial neoplasia ; Laryngeal carcinoma
Published in:	European archives of oto-rhino-laryngology, Vol. 278 (october 2020) , p. 1717-1722, ISSN 1434-4726

Part II de l'article: https://ddd.uab.cat/record/241081
DOI: 10.1007/s00405-020-06403-y
PMID: 33051798

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