OBJECTIVE

To investigate the diagnostic value of the fasting hypopharyngeal salivary pepsin concentration test for laryngopharyngeal reflux disease (LPRD).

METHODS

Volunteers were grouped by reflux symptom index scale, reflux finding score scale, and 24-h hypopharyngeal-esophageal multichannel intraluminal impedance with pH monitoring results. The study comprised 56, 27, and 20 individuals in the LPRD, asymptomatic laryngopharyngeal reflux (LPR), and asymptomatic non-LPR groups, respectively. All underwent a fasting hypopharyngeal saliva pepsin testing via enzyme-linked immunosorbent assay. Statistical analysis determined the optimal diagnostic cutoff value, sensitivity, and specificity of hypopharyngeal salivary pepsin for LPRD. Correlation analysis was performed with reflux scale scores and LPR parameters.

RESULTS

Fasting hypopharyngeal salivary pepsin concentration in the LPRD group was significantly higher than in the asymptomatic control group ( = -4.724,  < 0.05). The area under the receiver operating characteristic curve (AUC) analysis identified an optimal cutoff value of 29.62 ng/mL for salivary pepsin concentration (AUC, 0.767; sensitivity, 51.8%; and specificity, 93.6%). There was no statistically significant difference in salivary pepsin concentration between the asymptomatic LPR and non-LPR groups. The concentration was higher in the LPRD group than in the asymptomatic LPR and non-LPR groups ( < 0.05). Fasting hypopharyngeal salivary pepsin concentration exhibited a weakly positive correlation with vocal cord edema, intralaryngeal mucus adherence, excess throat mucus or postnasal drip, coughing during meals/lying down, troublesome or annoying cough, and liquid and weakly acidic reflux episodes.

CONCLUSIONS

The fasting hypopharyngeal salivary pepsin concentration test is a highly specific, simple, and noninvasive method with significant clinical diagnostic value for LPRD.