H.pylori and Pepsin as a Putative Risk Factors in Laryngeal Cancer Patients.

Abstract

Background: Laryngeal cancer constitutes 26-30% of all head and neck malignant tumors. Chronic stimulation by acid reflux may lead to a malignant change in the laryngopharyngeal mucosa. Pepsin assay could be a rapid, sensitive, and specific diagnostic marker of extra-esophageal reflux (EES). Helicobacter pylori is involved in the pathogenesis of peptic ulcer, and gastric carcinoma with growing interest in the presence of Helicobacter pylori in the upper aerodigestive tract.Aim: The aim of the study is to confirm the role of H.pylori and pepsin as risk factors in laryngeal cancer patients.Patients and Methods: Seventy-five patients were enrolled in this study, and divided into 3 groups; Group (A) 32 patients with suspected laryngeal malignancy. Group (B) 20 patients with benign laryngeal lesions. Group (C) 22 patients free from laryngeal disease, scheduled for non-laryngeal surgery. All patients were subjected to laryngo-pharyngeal lavage (LPL) using sterile water, before starting the surgical procedure and was analyzed for detection of Pepsin an H. Pylori, also culture for H. Pylori was done.Results: Strong positive association exist between H. pylori and Pepsin and occurrence of laryngeal carcinoma, while there was no statistically significant relationship with occurrence of a benign laryngeal lesions.Conclusion: GER is a risk factor or co-carcinogen in the pathogenesis of laryngeal carcinoma and not considered as a risk factor for benign laryngeal lesions. H. pylori culture and Pepsin assay in LPL can be used as non-invasive tool for detection of GER.