Department of Otolaryngology Head and Neck Surgery, Chinese People's Liberation Army General Hospital-Sixth Medical Centre, Beijing, China.
Department of Otorhinolaryngology, Affiliated Hospital of Chengde Medical College, Chengde, China.
Acta Otolaryngol. 2020 Aug;140(8):702-705. doi: 10.1080/00016489.2020.1758774. Epub 2020 May 13.
Pepsin immunohistochemical (IHC) staining is a promising diagnostic approach of laryngopharyngeal reflux (LPR). The interarytenoid mucosa has been proved to be an effective biopsy area. To investigate whether positive result of pepsin IHC staining in laryngeal lesions can predict LPR. The study included 136 patients with laryngeal cancer or vocal cord leukoplakia. 24 h multichannel intraluminal impedance-pH (MII-pH) was performed before operation, and pepsin IHC staining was performed on pathological sections after operation. The results of the two methods were compared. Among the 136 patients, 101 with at least one LPR event were regarded as MII-pH positive group, and another 35 were negative. The positive rate of pepsin IHC staining was 93.1% in MII-pH positive group and 54.1% in MII-pH negative group ( < .05). If the MII-pH results were used as a reference, the sensitivity and specificity of pepsin IHC staining in the diagnosis of LPR were 93.1 and 45.7%, respectively. The consistency of pepsin IHC and MII-pH was moderate (Kappa value = 0.452). The sensitivity of pepsin IHC staining in laryngeal lesions for diagnosing LPR is satisfactory. The existence of false negative of MII-pH may be the main reason for the low specificity.
胃蛋白酶免疫组织化学（IHC）染色是一种有前途的诊断喉咽反流（LPR）的方法。已证明杓状软骨间黏膜是有效的活检区域。本研究旨在探讨喉内病变中胃蛋白酶 IHC 染色阳性结果是否可以预测 LPR。该研究纳入了 136 例喉癌或声带白斑患者。所有患者在术前均进行了 24 小时多通道腔内阻抗-pH（MII-pH）检测，术后对病理切片进行胃蛋白酶 IHC 染色。比较两种方法的结果。136 例患者中，101 例至少有 1 次 LPR 事件，被视为 MII-pH 阳性组，另外 35 例为 MII-pH 阴性组。MII-pH 阳性组胃蛋白酶 IHC 染色的阳性率为 93.1%，MII-pH 阴性组为 54.1%（<0.05）。如果以 MII-pH 结果为参考，胃蛋白酶 IHC 染色诊断 LPR 的敏感性和特异性分别为 93.1%和 45.7%。胃蛋白酶 IHC 染色与 MII-pH 的一致性为中度（Kappa 值=0.452）。胃蛋白酶 IHC 染色在诊断 LPR 方面的敏感性满意。MII-pH 存在假阴性可能是特异性低的主要原因。
