Background. Gastroesophageal reflux is suspected to be an etiological factor in laryngeal and pharyngeal cancer. The aim of this study was to establish, using a non-invasive method, whether laryngopharyngeal reflux (LPR) appears more often in patients with early laryngeal cancer than in a control group.
Patients and methods. We compared the pH, the level of bile acids, the total pepsin and the pepsin enzymatic activity in saliva in a group of 30 patients with T1 laryngeal carcinoma and a group of 34 healthy volunteers.
Results. The groups differed significantly in terms of levels of total pepsin and bile acids in the saliva sample. Higher levels of total pepsin and bile acids were detected in the group of cancer patients. No significant impact of other known factors influencing laryngeal mucosa (e.g. smoking, alcohol consumption, and the presence of irritating substances in the workplace) on the results of saliva analysis was found.
Conclusions. A higher level of typical components of LPR in the saliva of patients with early laryngeal cancer than in the controls suggests the possibility that LPR, especially biliary reflux, has a role in the development of laryngeal carcinoma.
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1. Koufman JA Dettmar PW Johnston N. Laryngopharyngeal reflux (LPR). ENT News 2005; 14: 42-5.
2. De Corso E Baroni S Agostino S Cammarota G Mascagna G Mannocci A et al. Bile acids and total bilirubin detection in saliva of patients submitted to gastric surgery and in particular to subtotal billroth II resection. Ann Surg 2007; 245: 880-5.
3. Tae K Jin BJ Ji YB Jeong JH Cho SH. The role of laryngopharyngeal reflux as a risk factor in laryngeal cancer: A preliminar report. Clin Exp Otorhinolaryngol 2011; 4: 101-4.
4. Dagli S Dagli U Kurtaran H Alkim C Sahin B. Laryngopharyngeal reflux in laryngeal cancer. Turk J Gastroenterol 2004; 15: 77-81.
5. Lewin JS GillenwaterAM Garret JD. Characterization of laryngopharyngeal reflux in patients with premalignant or early carcinomas of the larynx. Cancer 2003; 97: 1010-4.
6. Galli J Cammarota G Volante M De Corso E Almadori G PaludettiG. Laryngeal carcinoma and laryngo-pharyngeal reflux disease. Acta Otorhinolaryngol Ital 2006; 26: 260-3.
7. Quadeer MA Lopez R Wood BG. Does acid suppresive therapy reduce the risk of laryngeal cancer recurrence? Laryngoscope 2005; 115: 1877-81.
8. Copper MP Smit CF Stanojcic LD Devriese PP Schouwenburg PF Mathus- Vliegen LM. High incidence of laryngeal reflux in patients with head and neck cancer. Laryngoscope 2000; 110: 1007-11.
9. Belafsky PC Postma GN Koufman JA. Validity and reliability of the reflux Symptom Index (RSI). J Voice 2002; 16: 274-7.
10. Samuels TL Johnston N. Pepsin as a marker of extraesophageal reflux. Ann Otol Rhinol Laryngol 2010; 119: 203-8.
11. Knight J Liveloy MO Johnston N Dettmar PW Koufman JA. Sensitive Pepsin immunoassay for detection of laryngopharyngeal reflux. Laryngoscope 2005; 115: 1473-8.
12. Buyukasik O Hasdemir AO Gulnerman Y Col C Ikiz O. Second primary cancers in patients with gastric cancer. Radiol Oncol 2010; 44: 239-43.
13. La Vecchia C Zhang ZF Altieri A. Alcohol and laryngeal cancer: an update. Eur J Cancer Prev 2008; 17: 116-24.
14. Hashibe M Boffetta P Zaridze D Shangina O Szeszenia-Dabrowska N Mates IN et al. Contribution of tobacco and alcohol to the high rates of squamous cell carcinoma of the supraglottic and glottic in Central Europe. Am J Epidemiol 2007; 165: 814-20.
15. Elci OC Akpinar-Elci M. Occupational exposures and laryngeal cancer among non-smoking and non-drinking men. Int J Occup Environ Health 2009; 15: 370-3.
16. Peszynska-Piorun M Malicki J Golusinski W. Doses in organs at risk during head and neck radiotherapy using IMRT and 3D-CRT. Radiol Oncol 2012; 46: 328-36.
17. Vitale GC Cheadle WG Patel B Sadek Sa Michel ME Cusechieri A. The effect of alcohol on nocturnal gastroesophagealrefluks. JAMA 1987; 16: 258: 2077-9.
18. Majchrzak E Szybiak B Wegner A Pienkowski P Pazdrowski J Luczewski L et al. Oral cavity and oropharyngeal squamous cell carcinoma in young adults: a review of the literature. Radiol Oncol 2014; 48: 1-10.
19. Saruc M Aksoy EA Vardereli E Karaaslan M Cicek B Ince U et all. Risk factors for laryngopharyngeal reflux. Eur Arch Otorhinolaryngol 2012; 269: 1189-96.
20. Phua SY. McGarvey L Ngu M Ing A. The differential effect of gastroesophageal reflux disease on mechanostimulation and chemostimulation of the laryngopharynx. Chest 2010; 138: 180-5.