Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, U.S.A.
Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown, West Virginia, U.S.A.
Laryngoscope. 2024 Mar;134(3):1147-1154. doi: 10.1002/lary.31027. Epub 2023 Sep 22.
Globus pharyngeus (GP) is a perplexing problem that accounts for 4% of referrals to otolaryngologists. Workup can be extensive and may not be definitive in terms of etiology. The concern that lingers is that of a subtle cancer, which can prolong anxiety and increase testing cost. The aim of this study was to identify the incidence of head and neck cancer (HNC) in patients diagnosed with GP.
Longitudinal data were captured from two academic institutions, identifying patients with a new diagnosis of globus pharyngeus in 2015. The patient cohort was tracked for at least 4 years to assure follow-up and ability to determine if a HNC developed. Additional demographic data was also collected to determine most common consults, treatments, and testing employed.
Excluding patients with previous diagnosis of HNC, 377 patients were identified who presented with GP in 2015 that had at least 4 years of follow-up. Demographics were predominantly women (64.65%), with a mean age of 56.48 years at diagnosis, and the most common provider specialty on the first visit was otolaryngology (39.52%). Four patients ultimately developed HN cancer, for an overall incidence of 1% for the 4-year period of 2015-2019.
Given the long-term follow-up of this population, the overall incidence of developing a head and neck cancer, with a presenting symptom of globus, is low. This is the largest study to date to report the percentage of patients endorsing GP to then subsequently develop HNC. This helps otolaryngologists to reassure patients who have a normal comprehensive exam, flexible endoscopy, and targeted studies.
4 Laryngoscope, 134:1147-1154, 2024.
咽异感症（GP）是耳鼻喉科转诊患者的 4%的常见病因。其检查可能广泛但病因诊断不一定明确。患者持续担忧的是潜在的癌症，这会延长焦虑并增加检查费用。本研究旨在确定诊断为 GP 的患者中头颈部癌症（HNC）的发病率。
从两所学术机构中获取了纵向数据，以确定 2015 年新诊断为咽异感症的患者。对患者队列进行了至少 4 年的跟踪，以确保随访并确定是否发生 HNC。还收集了其他人口统计学数据，以确定最常见的就诊、治疗和检查方法。
排除了先前诊断为 HNC 的患者，共确定了 377 名 2015 年出现 GP 且至少随访 4 年的患者。患者的人口统计学特征主要为女性（64.65%），诊断时的平均年龄为 56.48 岁，首次就诊时最常见的专科为耳鼻喉科（39.52%）。最终有 4 名患者发展为 HNC，4 年期间的总发病率为 1%（2015-2019 年）。
考虑到该人群的长期随访，出现咽异感症这一症状并随后发展为 HNC 的总体发病率较低。这是迄今为止报告出现咽异感症继而发展为 HNC 的患者比例的最大研究。这有助于耳鼻喉科医生安抚那些接受过全面检查、灵活内镜检查和靶向研究的患者。
4 级喉镜，134：1147-1154，2024 年。
