Department of Otorhinolaryngology-Head Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Department of Otolaryngology Head and Neck Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China.
ORL J Otorhinolaryngol Relat Spec. 2021;83(3):159-166. doi: 10.1159/000512527. Epub 2021 Mar 23.
Vocal fold leukoplakia (VFL) has a risk of malignant transformation, and the underlying mechanisms are currently unrecognized. Some clinical evidence has indicated that laryngopharyngeal reflux (LPR) probably plays a critical role.
To explore the risk factors associated with the occurrence of VFL and to investigate the importance of LPR in VFL and its different pathological types using 24-h multichannel intraluminal impedance-pH monitoring.
Eighty-one patients with VFL and 27 healthy volunteers were recruited. General information and LPR parameters were analyzed.
The monitoring showed that 35.8% (29/81) of patients had acidic LPR and that 43.2% (35/81) had weakly acidic LPR. Heavy drinking (odds ratio = 4.004, p = 0.037) and acidic LPR (odds ratio = 4.471, p = 0.029) were independent risk factors for the occurrence of VFL. Acidic LPR showed a strong correlation with the Reflux Finding Score (p < 0.05) in patients suspected of having LPR based on the scale score. Meanwhile, weakly acidic LPR parameters increased with the severity of pathological degrees which were higher in high-grade dysplasia (p < 0.05).
Our study confirms the importance of LPR in VFL. Heavy drinking patients with VFL, particularly those with acidic LPR, should undergo intensive treatment. Meanwhile, weakly acidic LPR may play a critical role in the pathological changes in VFL.
声带白斑(VFL)有恶变的风险,其潜在机制目前尚不清楚。一些临床证据表明,喉咽反流(LPR)可能起着关键作用。
通过 24 小时多通道腔内阻抗-pH 监测,探讨与 VFL 发生相关的危险因素,并研究 LPR 在 VFL 及其不同病理类型中的重要性。
招募了 81 例 VFL 患者和 27 名健康志愿者。分析了一般资料和 LPR 参数。
监测显示,35.8%(29/81)的患者存在酸性 LPR,43.2%(35/81)的患者存在弱酸性 LPR。大量饮酒(比值比=4.004,p=0.037)和酸性 LPR(比值比=4.471,p=0.029)是 VFL 发生的独立危险因素。在基于评分的 LPR 可疑患者中,酸性 LPR 与反流发现评分(p<0.05)具有很强的相关性。同时,弱酸性 LPR 参数随着病理程度的严重程度而增加,在高级别发育不良中更高(p<0.05)。
本研究证实了 LPR 在 VFL 中的重要性。有 VFL 且大量饮酒的患者,特别是有酸性 LPR 的患者,应进行强化治疗。同时,弱酸性 LPR 可能在 VFL 的病理变化中起着关键作用。