Department of Pathology, Ningbo Diagnostic Pathology Center, Ningbo, China; Department of Histopathology, Ningbo Clinical Pathology Diagnosis Center, Ningbo, China.
Department of Otolaryngology Head and Neck Surgery, Nanjing Tongren Hospital, School of Medicine, Southeast University, Nanjing, China.
J Voice. 2024 Sep;38(5):1200-1206. doi: 10.1016/j.jvoice.2022.02.025. Epub 2022 Apr 19.
To explore the correlation between detection results of pepsin in vocal fold polyp tissues and the postoperative efficacy.
The clinical data of 112 patients with vocal fold polyp who received surgical procedures in our hospital from June 2019 to March 2021 were retrospectively analyzed. The vocal fold morphology and vocal acoustic function were assessed at postoperative week 12. Using binary logistic regression, we explored whether the factors, ie, detection result of pepsin in vocal fold polyp tissue, microscopic suturing, the use of CO laser, and the history of smoking, affected the postoperative morphological repair of vocal fold polyps. Then, to observe and compare the influence of the detection results of pepsin on the recovery of vocal acoustic function, we divided the enrolled patients into the pepsin group and the pepsin-free group based on the postoperative detection results of pepsin in the polyp tissues by immunohistochemistry, RESULTS: In the 112 patients with vocal fold polyps, positive staining of pepsin in the postoperative samples was found in 76 patients (67.86%) and negative in 36 (32.14%). Totally 80 patients returned to normal in vocal fold morphology, among whom 32 (88.89%) were in pepsin-free group and 48 (63.16%) in pepsin group. Binary logistic regression showed that pepsin was a clinically significant indicator that affected the postoperative morphological recovery of the vocal fold (P = 0.003). Although hoarse voice was improved in all patients at postoperative week 12, the differences were statistically significant in the proportion of patients with grade, roughness, breathiness, asthenia, strain class G, voice handicap index, maximum phonation time, Jitter, Shimmer and noise-to-harmonic ratio between the pepsin group and the pepsin-free group (P < 0.05), with the pepsin-free group being superior to the pepsin group in the improvement of vocal acoustic function.
Pepsin in vocal fold polyps is a clinically significant indicator affecting the postoperative morphological recovery and acoustic efficacy, and patients with negative pepsin are superior to those with positive pepsin in the postoperative recovery of vocal fold morphology and function.
探讨声带息肉组织中胃蛋白酶检测结果与术后疗效的相关性。
回顾性分析我院 2019 年 6 月至 2021 年 3 月收治的 112 例行手术治疗的声带息肉患者的临床资料。术后第 12 周评估声带形态和嗓音声学功能。采用二项逻辑回归分析探讨胃蛋白酶在声带息肉组织中的检测结果、显微镜缝合、CO2 激光应用、吸烟史等因素是否影响声带息肉的术后形态修复。然后，通过免疫组织化学法检测术后息肉组织中胃蛋白酶的检测结果，观察并比较胃蛋白酶的检测结果对嗓音声学功能恢复的影响，将纳入患者分为胃蛋白酶组和胃蛋白酶阴性组。
112 例声带息肉患者中，术后标本胃蛋白酶阳性 76 例（67.86%），阴性 36 例（32.14%）。80 例患者声带形态恢复正常，其中胃蛋白酶阴性组 32 例（88.89%），胃蛋白酶组 48 例（63.16%）。二项逻辑回归显示，胃蛋白酶是影响声带形态术后恢复的有临床意义的指标（P=0.003）。虽然所有患者在术后第 12 周时声音嘶哑均有改善，但胃蛋白酶组和胃蛋白酶阴性组间患者等级、粗糙、气息声、无力、G 类、嗓音障碍指数、最大发音时间、抖动、振幅微扰比、噪声与谐噪比的比例差异均有统计学意义（P<0.05），胃蛋白酶阴性组在改善嗓音声学功能方面优于胃蛋白酶组。
声带息肉中的胃蛋白酶是影响术后形态恢复和声学疗效的有临床意义的指标，胃蛋白酶阴性患者的声带形态和功能术后恢复优于胃蛋白酶阳性患者。
