Laryngoscopy-based scoring system for the diagnosis of vocal fold
leukoplakia: A preliminary study
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.