UNASSIGNED: To evaluate the rate of and time to malignant transformation of dysplastic laryngeal lesions based on the World Health Organization (WHO) dysplasia classification system.
UNASSIGNED: PubMed, MEDLINE, Embase, CINAHL, CENTRAL, and Cochrane Reviews were searched from the date of database inception to June 8, 2023.
UNASSIGNED: English-language articles assessing the rate of malignant transformation using the 2005 WHO dysplasia classification system were included in this systematic review and meta-analysis.
UNASSIGNED: The study was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Data extraction was performed by 2 independent investigators. Study quality was assessed using a validated quality tool. When possible, data were pooled using random-effects meta-analysis.
UNASSIGNED: The primary outcome measure was the malignant transformation rate in each laryngeal dysplasia category. Secondary outcome measure was the time interval over which malignant transformation had occurred.
UNASSIGNED: A total of 5585 records were screened, 61 full texts were assessed, and 18 retrospective cohort studies with 3243 participants were included in the final review. The weighted pooled mean malignant transformation rates of mildly, moderately, and severely dysplastic lesions were 10.9%, 23.3%, and 30.5%, respectively. Malignant transformation rate of nondysplastic laryngeal lesions was 4.5%. Moderately and severely dysplastic lesions had significantly higher odds of malignant transformation compared with mildly dysplastic lesions (moderate: odds ratio [OR], 2.90 [95% CI, 2.06-4.09]; I2 = 0%; severe: OR, 3.42 [95% CI, 2.11-5.52]; I2 = 40%). Lesions without dysplasia had a significantly lower odds of malignant transformation compared with lesions with mild dysplasia (OR, 0.48; 95% CI, 0.28-0.81; I2 = 0%). The overall mean time to malignant transformation was 28.8 months (range, 22.0-35.6 months) for all dysplasia grades.
UNASSIGNED: This systematic review and meta-analysis found that the rate of malignant transformation increased with the grade of laryngeal dysplasia. Moderately dysplastic lesions were more likely to undergo malignant degeneration compared with mildly dysplastic lesions.
■根据世界卫生组织(WHO)的发育异常分类系统,评估增生性喉部病变的恶性转化率和时间。
■PubMed,MEDLINE,Embase,CINAHL,中部,和CochraneReviews从数据库开始之日到2023年6月8日进行了搜索。
■使用2005年WHO异型增生分类系统评估恶性转化率的英文文章纳入本系统综述和荟萃分析。
■根据系统评价和荟萃分析(PRISMA)报告指南报告本研究。数据提取由2名独立研究者进行。使用经过验证的质量工具评估研究质量。如果可能,数据采用随机效应荟萃分析进行汇总.
■主要结果指标是每个喉发育不良类别的恶性转化率。次要结果指标是发生恶性转化的时间间隔。
■共筛选了5585条记录,评估了61篇全文,最终综述中纳入了18项回顾性队列研究,共3243名参与者.加权合并平均恶性转化率为轻度,适度,严重发育不良病变占10.9%,23.3%,30.5%,分别。非增生性喉病变的恶性转化率为4.5%。与轻度发育不良病变相比,中度和重度发育不良病变的恶性转化几率明显更高(中度:优势比[OR],2.90[95%CI,2.06-4.09];I2=0%;严重:OR,3.42[95%CI,2.11-5.52];I2=40%)。与轻度异型增生的病变相比,无异型增生的病变的恶变几率显着降低(OR,0.48;95%CI,0.28-0.81;I2=0%)。恶性转化的总平均时间为28.8个月(范围,22.0-35.6个月)对于所有发育不良等级。
■这项系统综述和荟萃分析发现,随着喉发育不良的分级,恶变率增加。与轻度发育不良病变相比,中度发育不良病变更容易发生恶性变性。