喉癌中的喉咽反流

Laryngopharyngeal reflux in laryngeal cancer.

作者信息

Dağli Safak, Dağli Ulkü, Kurtaran Hanifi, Alkim Canan, Sahin Burhan

机构信息

II. KBB Clinic, Ankara Numune Hospital, Ankara, Turkey.

出版信息

Turk J Gastroenterol. 2004 Jun;15(2):77-81.

PMID:15334314

Abstract

BACKGROUND/AIMS: Gastropharyngeal or laryngopharyngeal reflux is considered as a factor in various diseases of the larynx and pharynx. The most important consequence of the reflux into the larynx is laryngeal cancer.

METHODS

In this prospective study the incidence of gastropharyngeal and laryngopharyngeal reflux in 22 patients with untreated laryngeal cancer was investigated with 24-hour, double probe pH measurements. A group of 25 patients with heartburn and dyspepsia complaints in whom esophagogastroscopy revealed no pathology and for whom 24-hour pH measurement was indicated served as a control group.

RESULTS

Two of the 22 patients never smoked and two others had quit smoking 16 and 25 years previously. All four of these patients revealed gastropharyngeal reflux. In total, 14 of the laryngeal cancer patients (63.6%) revealed gastropharyngeal reflux. The rate of gastroesophageal reflux was close among the two groups (50% in the cancer group vs 32% in the control group, p>0.05), but the laryngopharyngeal reflux rate was much higher in the cancer group (63.6% of the cancer patients vs 20% in the control group, p: 0.003). Among the reflux-positive patients and the controls, gastroesophageal reflux rate was higher in the supine position in cancer patients (12.10% vs 6.25, p: 0.02). In the upright position, control cases revealed higher rates of gastroesophageal reflux than the cancer patients. Laryngopharyngeal reflux rates were slightly higher in laryngeal cancer patients than the controls in both upright (9.29% vs 7.67%, p: 0.6) and supine positions (4.83% vs 3.50%, p: 0.6).

CONCLUSIONS

Laryngeal cancer patients and patients with heartburn complaints all have a high rate of gastroesophageal reflux. But cancer patients reveal a higher rate of laryngopharyngeal reflux than the symptomatic patients with normal laryngeal findings.

摘要

背景/目的：胃咽反流或喉咽反流被认为是导致喉和咽多种疾病的一个因素。反流至喉部最重要的后果是喉癌。

方法

在这项前瞻性研究中，通过24小时双探头pH测量，对22例未经治疗的喉癌患者的胃咽反流和喉咽反流发生率进行了调查。选取25例有烧心和消化不良症状且食管胃镜检查未发现病变并进行了24小时pH测量的患者作为对照组。

结果

22例患者中有2例从不吸烟，另外2例分别在16年和早前25年戒烟。这4例患者均出现胃咽反流。总体而言，14例喉癌患者（63.6%）出现胃咽反流。两组的胃食管反流率相近（癌症组为50%，对照组为32%，p>0.05），但癌症组的喉咽反流率更高（癌症患者中为63.6%，对照组为20%，p：0.003）。在反流阳性患者和对照组中，癌症患者仰卧位时的胃食管反流率更高（12.10%对6.25，p：0.02）。直立位时，对照组的胃食管反流率高于癌症患者。在直立位（9.29%对7.67%，p：0.6）和仰卧位（4.83%对3.50%，p：0.6）时，喉癌患者的喉咽反流率均略高于对照组。