Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France.
Department of Otolaryngology, Polyclinic of Poitiers, Elsan Hospital, Poitiers, France.
Otolaryngol Head Neck Surg. 2023 Jul;169(1):97-104. doi: 10.1177/01945998221121822. Epub 2023 Jan 29.
To investigate the sensitivity (SE), specificity (SP), and positive and negative predictive value (PPV and NPV) of symptoms and signs of laryngopharyngeal reflux (LPR).
Prospective controlled.
University medical center.
Patients presenting with LPR symptoms and signs were consecutively included after diagnosis confirmation through 24-hour hypopharyngeal-esophageal multichannel intraluminal impedance-pH monitoring. Healthy individuals were recruited to compose a control group. Symptoms and signs were evaluated with the reflux symptom score and reflux sign assessment. The SE, SP, PPV, and NPV of symptoms and signs were assessed.
The study included 403 patients with LPR and 144 healthy individuals. Throat clearing, globus sensation, heartburn, and excess throat mucus were symptoms with the highest SE (67.5%-69.7%), SP (12.5%-20.8%), and NPV (48.3%-49.2%). The combination of throat clearing, heartburn, globus sensation, and excess throat mucus led to a high SE (96.0%) and NPV (85.2%). Anterior pillar erythema, tongue tonsil hypertrophy, and posterior commissure hypertrophy resulted in the highest SE (75.5%-83.5%). The highest SP was found for uvula erythema/edema, epiglottis erythema, and interarytenoid granulatory tissue (97.1%-97.2%). The association of nonendoscopic signs (anterior pillar erythema, uvula erythema/edema, and coated tongue) had an SE and SP of 80.1% and 47.2%, respectively. The association of throat clearing, heartburn, globus, anterior pillar erythema, and uvula erythema/edema had the highest SE (98.8%), SP (33.3%), PPV (94.3%), and NPV (70.6%).
LPR symptoms and signs reported low SP and NPV. The SE, SP, PPV, and NPV may be maximized with the association of throat clearing, heartburn, globus sensation, anterior pillar erythema, and uvula erythema/edema.
研究喉咽反流（LPR）症状和体征的敏感性（SE）、特异性（SP）、阳性和阴性预测值（PPV 和 NPV）。
前瞻性对照。
大学医学中心。
通过 24 小时下咽食管多通道腔内阻抗-pH 监测确诊 LPR 症状和体征后，连续纳入出现 LPR 症状和体征的患者。招募健康个体组成对照组。采用反流症状评分和反流体征评估来评估症状和体征。评估症状和体征的 SE、SP、PPV 和 NPV。
本研究纳入了 403 例 LPR 患者和 144 名健康个体。清嗓、异物感、烧心和咽喉部黏液过多是 SE（67.5%-69.7%）、SP（12.5%-20.8%）和 NPV（48.3%-49.2%）最高的症状。清嗓、烧心、异物感和咽喉部黏液过多的联合应用可获得较高的 SE（96.0%）和 NPV（85.2%）。前柱红斑、舌扁桃体肥大和后连合肥大导致 SE 最高（75.5%-83.5%）。悬雍垂红斑/水肿、会厌红斑和杓间区肉芽组织的 SP 最高（97.1%-97.2%）。非内镜下体征（前柱红斑、悬雍垂红斑/水肿和舌苔）联合应用的 SE 和 SP 分别为 80.1%和 47.2%。清嗓、烧心、异物感、前柱红斑和悬雍垂红斑/水肿的联合应用具有最高的 SE（98.8%）、SP（33.3%）、PPV（94.3%）和 NPV（70.6%）。
LPR 症状和体征的 SP 和 NPV 较低。通过清嗓、烧心、异物感、前柱红斑和悬雍垂红斑/水肿的联合应用，可以最大限度地提高 SE、SP、PPV 和 NPV。
