Correlating intraepithelial papillary capillary loops of vocal cord leukoplakia with histopathology

Background The pathology of vocal fold leukoplakia (VFL) was hard to predict before surgery. Objectives To investigate the correlation of intraepithelial papillary capillary loops (IPCLs) with the malignant transformation in VFL. Materials and Methods The IPCLs in 90 patients were classified according to 2019 Ni classification. Type I-III represented to non- to moderate dysplasia in pathology being viewed as 'benign leukoplasia', type IV-VI represented to severe dysplasia/cancer in situ, cancerization being viewed as 'malignant leukoplasia'. The corresponding relationship of IPCLs with pathology was calculated. Results Forty-one cases were classified as type I-III, the consistency of type I-III with pathology was 61.0%, with 100.0% of type I, 47.1% of type II and 30.0% of type III. 49 cases were classified as type IV-VI, all were 'malignant leukoplasia', the consistency of type IV-VI and pathology was 100.0%. The accuracy of type I-III, IV-VI to predict pathology were 61.0, 100.0%. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value of Ni classification corresponding to 'benign/malignant leukoplasia' was 75.8, 100.0, 82.2, 100.0, 60.0%, respectively. Conclusions and Significance IPCLs of type IV-VI in vocal cord leukoplasia had a close correlation with pathology. The degree of dysplasia was underestimated in type II and type III.