Mayo Clinic Alix School of Medicine, Scottsdale, AZ, United States of America.
Mayo Clinic College of Medicine and Science, Scottsdale, AZ, United States of America.
Am J Otolaryngol. 2020 Nov-Dec;41(6):102653. doi: 10.1016/j.amjoto.2020.102653. Epub 2020 Aug 5.
Gastroesophageal reflux disease (GERD) has been associated with head and neck cancer (HNC), including laryngeal and pharyngeal anatomical sites. A systematic review and meta-analysis was performed to examine these associations.
Articles were retrieved from the Medline, Web of Science, Scopus, and Embase databases using keywords "gastroesophageal reflux disease", "laryngopharyngeal reflux", "head and neck cancer", and associated variants. Inclusion criteria were English language publications, human subjects, and controlled studies with described development of head and neck cancer among individuals with GERD. 13 studies with a total of 39,824 patients were included.
Overall, presence of GERD was associated with an increased risk of developing HNC (OR = 1.86, 95% Confidence Interval [CI] = 1.27-2.74). This association remained significant with laryngeal cancers (OR = 1.95, 95% CI = 1.33-2.86), but not pharyngeal cancers (OR = 1.56, 95% CI = 0.86-2.83). Subgroup analyses of hypopharyngeal (OR = 2.26, 95% CI = 0.67-7.68) and oropharyngeal subsites (OR = 1.39, 95% CI = 0.51-3.84) were not statistically significant. Meta-analysis of studies that objectively assessed reflux, such as pH monitor placement, showed statistical significance (OR = 2.81, 95% CI = 1.36-5.81), while studies that used subjective reporting or chart review of GERD were not significant (OR = 1.46, 95% CI = 0.89-2.40). Association between H. pylori infection and head and neck cancers was not statistically significant (OR = 2.66, 95% CI = 0.59-11.97).
A diagnosis of GERD is associated with a later diagnosis of HNC, but this association is not significant for pharyngeal cancers. Associations of GERD with HNC may be specific to laryngeal cancers.
Systematic review and meta-analysis of case control studies (3a).
胃食管反流病（GERD）与头颈部癌症（HNC）有关，包括喉和咽的解剖部位。进行了系统评价和荟萃分析，以检查这些关联。
使用关键字“胃食管反流病”、“喉咽反流”、“头颈部癌症”和相关变体，从 Medline、Web of Science、Scopus 和 Embase 数据库中检索文章。纳入标准为英语出版物、人体研究和描述 GERD 患者中头颈部癌症发展的对照研究。共纳入 13 项研究，总计 39824 例患者。
总体而言，GERD 的存在与发生 HNC 的风险增加相关（OR=1.86，95%置信区间[CI]=1.27-2.74）。这种关联在喉癌中仍然显著（OR=1.95，95%CI=1.33-2.86），但在咽癌中不显著（OR=1.56，95%CI=0.86-2.83）。下咽（OR=2.26，95%CI=0.67-7.68）和口咽亚部位（OR=1.39，95%CI=0.51-3.84）的亚组分析无统计学意义。客观评估反流的研究（如 pH 监测放置）的荟萃分析显示具有统计学意义（OR=2.81，95%CI=1.36-5.81），而使用 GERD 主观报告或图表审查的研究则不显著（OR=1.46，95%CI=0.89-2.40）。H. pylori 感染与头颈部癌症之间的关联无统计学意义（OR=2.66，95%CI=0.59-11.97）。
GERD 的诊断与 HNC 的后期诊断相关，但这种关联在咽癌中不显著。GERD 与 HNC 的关联可能特定于喉癌。
病例对照研究的系统评价和荟萃分析（3a）。
