Classification of etiology and pathology of laryngeal cancer

The cause of laryngeal cancer is still unclear. It may be related to long-term excessive smoking, long-term exposure to harmful chemical gases (such as nickel, chromium, uranium, etc.) and dust (such as asbestos, etc.), exposure to radiation, viral infection, long-term improper use of the throat, poor oral hygiene, laryngeal keratosis, vocal cord leukoplakia and other chronic laryngeal diseases. In recent years, some studies have shown that it is related to increased testosterone. The pathology of laryngeal cancer can be divided into squamous cell carcinoma, adenocarcinoma, undifferentiated carcinoma, lymphosarcoma, etc. according to pathological tissue classification. Among them, squamous cell carcinoma is the most common, accounting for about 95% of the incidence of laryngeal cancer, followed by adenocarcinoma and undifferentiated carcinoma. Lymphosarcoma and fibrosarcoma are rare.

According to the pathological morphology, it can be roughly divided into four types: cauliflower type, nodular type, infiltrative type, and ulcerative type.

According to the anatomical location, it is divided into four types: supraglottic, glottic, subglottic, and paraglottic, as shown below:

1. Supraglottic type: including cancers originating from the parts above the vocal cords, such as the epiglottis, ventricular band, aryepiglottic fold, etc. This type of laryngeal cancer is poorly differentiated and develops rapidly. The early symptoms are not obvious, only discomfort in the throat and foreign body sensation. After the tumor ulcerates, there will be throat pain or dry cough, and blood in the sputum in the late stage. If the tumor invades downward, hoarseness may occur, and the enlargement of the tumor blocking the laryngeal cavity may cause breathing difficulties. Due to the rich lymphatic tissue in the supraglottic area, cervical lymph node enlargement may occur earlier. Laryngoscopy can show cauliflower-like or nodular neoplasms in the larynx.

2. Glottic area type: This type of laryngeal cancer is confined to the vocal cords. There are more cases in the anterior and middle 1/2 and it is well differentiated. It is usually squamous cell carcinoma grade I or II and develops slowly. Hoarseness may occur in the early stage. If the tumor continues to grow, it may cause blood in the sputum and difficulty breathing. In the late stage, there will be sore throat, difficulty breathing and swollen cervical lymph nodes. Laryngoscopy can reveal localized protrusions or neoplasms on the vocal cords in the early stage with a rough and uneven surface. If the tumor enlarges, cauliflower-like or papillary masses may be seen in the larynx. If the tumor invades the cricoarytenoid joint or intrinsic laryngeal muscles, the vocal cord movement may be restricted or fixed.

3. Subglottic type: This type of laryngeal cancer refers to the cancer located below the vocal cords and above the lower edge of the cricoid cartilage. There are no symptoms in the early stage. As the tumor grows and invades the vocal cords, hoarseness, cough, and blood in sputum may occur. In the late stage, there is difficulty breathing. It may also penetrate the nail membrane, invade the thyroid gland and the soft tissue in the front of the neck, and infiltrate along the anterior wall of the esophagus. Laryngoscopy can reveal new growths in the subglottic area.

4. Paraglottic type: refers to primary cancer of the laryngeal ventricle mucosa. It may be asymptomatic in the early stage and is only discovered after hoarseness occurs. The course of the disease is long and the development is slow. If the condition further worsens, there may be sore throat and radiation to the ear. In the late stage, there are varying degrees of irritating dry cough and dyspnea symptoms.

The above is a brief introduction to the "Classification of the Causes and Pathologies of Laryngeal Cancer". For people who are related to the pathogenic factors of laryngeal cancer, it is recommended to take preventive measures for laryngeal cancer and receive specific treatment according to the doctor's instructions. I hope that patients can recover soon! If you have other questions about laryngeal cancer, please consult our experts online or call for consultation.

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