Author/Editor		Gale, Nina; Kambič, Vinko; Michaels, Leslie; Cardesa, Antonio; Hellquist, Henrik; Zidar, Nina; Poljak, Mario
Title		The Ljubljana classification: a practical strategy for the diagnosis of laryngeal precancerous lesions
Type		članek
Source		Adv Anat Pathol
Vol. and No.		Letnik 7, št. 4
Publication year		2000
Volume		str. 240-51
Language		eng
Abstract		There is no internationally accepted classification of epithelial hyperplastic laryngeal lesions (EHLL). The majority of current classification follow criteria similar to those commonly used for cervical epithelial lesions. However, the different etiology of laryngeal cancer and its particular clinical and histologic features necessitate a grading system more appropriate to this region. The Ljubljana classification of EHLL was devised in 1971 tp cater to this repairement. Detailed criteria for histologic grading in this classification were formulated by a working group on EHLL of the European Society of Pathology in 1999. The system recognizes four grades: simple and abnormal hyperplasia are benign categories; arypical hyperplasia ("risky" epithelium) is potentially malignant, and carcinoma in situ actually malignant. The main features by which the proposed grading system differs from other classifications are: 1. the distinction between benign and potentially malignant lesions; 2. the positive separation of carcinoma in situ from atypical hyperplasia; 3. the lack of prognostic significance for any surface keratin layer. The eventual outcome of EHLL patients so graded justifies the proposal for separating the lesions into a benign group, showing malignant transformation in only 0.9% of cases, from a potentially malignant group showing malignant transformation in 11% of cases. For diagnostically difficult cases, supplementary techniques such as those using morphometry, immunohistochemical and molecular biology are advised to improve the accuracy of diagnosis and predictions of their biological behavior.
Descriptors		LARYNGEAL NEOPLASMS PRECANCEROUS CONDITIONS LARYNGEAL DISEASES HYPERPLASIA CARCINOMA IN SITU