Health Service Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA.
Laryngoscope. 2011 Jan;121(1):102-5. doi: 10.1002/lary.21165.
OBJECTIVES/HYPOTHESIS: The relationship between gastroesophageal reflux disease (GERD) and laryngeal cancer has not been fully elucidated. This case-control study investigates whether GERD increases the odds of developing these malignancies.
Case-control study.
Rates of GERD among cases of laryngeal cancer identified in the Veterans Health Administration outpatient care files (year 2000-2006) were compared with controls. Cases (N = 14,449) were frequency matched 1:1 with controls. Multivariate logistic regression was used to determine the association between GERD and cancer.
After adjusting for tobacco and/or alcohol use, there was no association between GERD and laryngeal cancer (adjusted odds ratio, 1.01; 95% confidence interval, 0.92-1.12, P =.780). Although an association was found when time from GERD diagnosis to malignancy was less than 3 months, it disappeared when this period was extended further.
In this population, there was no increased risk of laryngeal cancer among patients with GERD. However, in subsite analysis, a possible relationship between GERD and glottic cancer was observed. Reverse causality must be considered in future studies assessing the relationship between reflux and laryngeal cancer to limit misclassification bias.
目的/假设：胃食管反流病（GERD）和喉癌之间的关系尚未完全阐明。本病例对照研究调查 GERD 是否会增加这些恶性肿瘤的发病风险。
病例对照研究。
通过比较退伍军人健康管理局门诊病历（2000-2006 年）中发现的喉癌病例的 GERD 发生率与对照组，评估 GERD 与癌症的关系。病例（N=14449）与对照组按 1:1 频率匹配。采用多变量逻辑回归确定 GERD 和癌症之间的关联。
调整烟草和/或酒精使用后，GERD 与喉癌之间无关联（调整后的比值比，1.01；95%置信区间，0.92-1.12，P=0.780）。尽管在 GERD 诊断后到恶性肿瘤的时间少于 3 个月时发现了关联，但当这一时间段延长时，该关联就消失了。
在该人群中，GERD 患者的喉癌发病风险没有增加。然而，在亚部位分析中，观察到 GERD 与声门癌之间可能存在关系。在评估反流与喉癌之间的关系的未来研究中，必须考虑反向因果关系，以限制分类错误的偏倚。
