Wang J S, Wu M K, Li J R
Department of Otorhinolaryngology Head and Neck Surgery, Navy General Hospital, Beijing 100048, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Aug 7;53(8):587-591. doi: 10.3760/cma.j.issn.1673-0860.2018.08.006.
To observe the incidence and to determine the significance of laryngopharyngeal reflux (LPR) in laryngeal cancer and vocal leukoplakia. The patients who had been diagnosed as laryngeal cancer or vocal leukoplakia between January 2014 and June 2017 were included in this study. All of them received 24-hour multichannel intraluminal impedance-pH monitoring. The prevalence of LPR and numerous parameters from the 24-hour pH monitoring in laryngeal cancer patient and vocal leukoplakia patient groups were analyzed. The chi-square test was used for counting data, test and Mann-Whitney were used for measuring data. In the 91 laryngeal cancer patients, the prevalence of pathologic LPR was 28.6%(26/91), the median number[(25), (75), (95)]of acid reflux events was 0[0, 3, 5], time of acid exposure was 0[0, 14, 234]s, number of weakly acidic reflux events was 3[0, 6, 11]. In the 54 vocal leukoplakia patients, the prevalence of pathologic LPR was 29.6%(16/54), the number of acid reflux events was 0[0, 3, 4], time of acid exposure was 0[0, 13, 118]s, number of weakly acidic reflux events was 1.5[0, 5, 9]. The incidence of LPR did not vary in the laryngeal cancer patient and vocal leukoplakia patient groups, but were both higher than healthy Chinese volunteers according to a report in the other literature. Furthermore, all the three patients with no history of tobacco or alcohol existed acid or weakly acidic reflux episodes. Laryngopharyngeal reflux might play a role as an etiologic factor in laryngeal cancer and vocal leukoplakia.
观察喉咽反流（LPR）在喉癌和声带白斑中的发病率，并确定其意义。本研究纳入了2014年1月至2017年6月期间被诊断为喉癌或声带白斑的患者。所有患者均接受24小时多通道腔内阻抗-pH监测。分析了喉癌患者组和声带白斑患者组中LPR的患病率以及24小时pH监测的众多参数。计数资料采用卡方检验，计量资料采用t检验和Mann-Whitney检验。91例喉癌患者中，病理性LPR的患病率为28.6%（26/91），酸反流事件的中位数[（25），（75），（95）]为0[0，3，5]，酸暴露时间为0[0，14，234]秒，弱酸性反流事件的数量为3[0，6，11]。54例声带白斑患者中，病理性LPR的患病率为29.6%（16/54），酸反流事件的数量为0[0，3，4]，酸暴露时间为0[0，13，118]秒，弱酸性反流事件的数量为1.5[0，5，9]。LPR的发病率在喉癌患者组和声带白斑患者组中没有差异，但根据其他文献报道，两者均高于健康中国志愿者。此外，所有3例无烟酒史的患者均存在酸或弱酸性反流发作。喉咽反流可能作为喉癌和声带白斑的病因发挥作用。
