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Liu S, Li C, Xu S, Guo Y, Luo H. Association Between Helicobacter pylori and Laryngopharyngeal Reflux Disease: A Systematic Review and Meta-Analysis. J Voice 2024:S0892-1997(24)00114-0. [PMID: 38644072 DOI: 10.1016/j.jvoice.2024.03.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND It is controversial that Helicobacter pylori (H pylori) is involved in the pathogenesis or development of laryngopharyngeal reflux disease (LPRD). OBJECTIVE To investigate the potential association between LPRD and H pylori infection. MATERIAL AND METHODS A systematic review was performed of studies assessing the diagnosis or treatment of LPRD among patients with H pylori infection. Data sources are PubMed/MEDLINE, EMBASE[Ovid], Cochrane Library, and Web of Science, and ClinicalTrials.gov. RESULTS Fifteen studies were analyzed in the review, with all eligible for the meta-analysis. A significant association between H pylori infection and LPRD was detected for higher rates of H pylori infection in patients with LPRD than in non-LPRD patients (relative risk (RR), 1.35; 95% CI, 1.12-1.63; P = 0.002), and H pylori-positive patients had a higher prevalence of LPRD than H pylori-negative patients (RR, 1.19; 95% CI, 1.07-1.31; P = 0.001). The prevalence of H pylori among patients with LPRD was 49% (95% CI, 36-61), the prevalence of H pylori among patients with non-LPRD was 35% (95% CI, 23-49). CONCLUSION AND SIGNIFICANCE The limited evidence indicated the association between LPRD risk and increased H pylori infection. Different population races, diagnostic approach to LPRD, variant H pylori testing methods, age and sex may contribute to the heterogeneity. Further well-designed studies regarding the efficacy of H pylori eradication in the treatment of LPRD are strongly recommended in the future.
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Affiliation(s)
- Siwei Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Pujiang Hospital, Minhang Branch of Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Changjiang Li
- Department of Otorhinolaryngology Head and Neck Surgery, Eye&ENT Hospital, Fudan University, Shanghai, PR China
| | - Siyan Xu
- Department of Otorhinolaryngology Head and Neck Surgery, Eye&ENT Hospital, Fudan University, Shanghai, PR China
| | - Yanan Guo
- Department of Otorhinolaryngology Head and Neck Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Huajie Luo
- Department of Otorhinolaryngology Head and Neck Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
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Strzelczyk JK, Świętek A, Hudy D, Gołąbek K, Gaździcka J, Miśkiewicz-Orczyk K, Ścierski W, Strzelczyk J, Misiołek M. Low Prevalence of HSV-1 and Helicobacter pylori in HNSCC and Chronic Tonsillitis Patients Compared to Healthy Individuals. Diagnostics (Basel) 2023; 13:diagnostics13101798. [PMID: 37238282 DOI: 10.3390/diagnostics13101798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/12/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
Recent studies identified viral and bacterial factors, including HSV-1 and H. pylori, as possible factors associated with diseases such as chronic tonsillitis and cancers, including head and neck squamous cell carcinoma (HNSCC). We assessed the prevalence of HSV-1/2 and H. pylori in patients with HNSCC, chronic tonsillitis, and healthy individuals using PCR after DNA isolation. Associations were sought between the presence of HSV-1, H. pylori, and clinicopathological and demographic characteristics and stimulant use. HSV-1 and H. pylori were most frequently identified in controls (HSV-1: 12.5% and H. pylori: 6.3%). There were 7 (7.8%) and 8 (8.6%) patients with positive HSV-1 in HNSCC and chronic tonsillitis patients, respectively, while the prevalence of H. pylori was 0/90 (0%) and 3/93 (3.2%), respectively. More cases of HSV-1 were observed in older individuals in the control group. All positive HSV-1 cases in the HNSCC group were associated with advanced tumor stage (T3/T4). The prevalence of HSV-1 and H. pylori was highest in the controls compared to HNSCC and chronic tonsillitis patients, which indicates that the pathogens were not risk factors. However, since all positive HSV-1 cases in the HNSCC group were observed only in patients with advanced tumor stage, we suggested a possible link between HSV-1 and tumor progression. Further follow-up of the study groups is planned.
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Affiliation(s)
- Joanna Katarzyna Strzelczyk
- Department of Medical and Molecular Biology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 19 Jordana St., 41-808 Zabrze, Poland
| | - Agata Świętek
- Department of Medical and Molecular Biology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 19 Jordana St., 41-808 Zabrze, Poland
- Silesia LabMed Research and Implementation Center, Medical University of Silesia in Katowice, 19 Jordana St., 41-808 Zabrze, Poland
| | - Dorota Hudy
- Department of Medical and Molecular Biology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 19 Jordana St., 41-808 Zabrze, Poland
| | - Karolina Gołąbek
- Department of Medical and Molecular Biology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 19 Jordana St., 41-808 Zabrze, Poland
| | - Jadwiga Gaździcka
- Department of Medical and Molecular Biology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 19 Jordana St., 41-808 Zabrze, Poland
| | - Katarzyna Miśkiewicz-Orczyk
- Department of Otorhinolaryngology and Oncological Laryngology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 10 C Skłodowskiej St., 41-800 Zabrze, Poland
| | - Wojciech Ścierski
- Department of Otorhinolaryngology and Oncological Laryngology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 10 C Skłodowskiej St., 41-800 Zabrze, Poland
| | - Janusz Strzelczyk
- Department of Endocrinology and Neuroendocrine Tumors, Department of Pathophysiology and Endocrinology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 35 Ceglana St., 40-514 Katowice, Poland
| | - Maciej Misiołek
- Department of Otorhinolaryngology and Oncological Laryngology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 10 C Skłodowskiej St., 41-800 Zabrze, Poland
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Joseph NA, Mathews SS, Anandan S, Veeraraghavan B, Bakthavatchalam YD, Pulimood AB. Lack of Association of Helicobacter pylori in Laryngeal Pathologies. Indian J Otolaryngol Head Neck Surg 2022; 74:2636-2642. [PMID: 36452618 PMCID: PMC9702011 DOI: 10.1007/s12070-020-02361-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 12/28/2020] [Indexed: 02/07/2023] Open
Abstract
To study the association of Helicobacter pylori (H. pylori) in patients with laryngeal pathologies. Study design: prospective observational study. Tertiary care teaching hospital. One hundred consecutive patients with laryngeal lesions scheduled for microlaryngoscopy were enrolled in the study. Laryngopharyngeal reflux was assessed using the reflux symptom index and reflux finding score. Tissue samples from the laryngeal lesions were taken under general anaesthesia and were screened for the presence of H. pylori using real time polymerase chain reaction (PCR) for ureA genes and histopathological examination. Of the 100 patients, 14 had a significant reflux symptom index score and 35 had significant reflux finding score. The lesions in the study subjects included both benign and malignant laryngeal pathologies. Vocal cord polyps formed more than half of the laryngeal pathology (57%) studied. Our study could not detect H. pylori in any laryngeal lesions by PCR analysis and histopathological examination. H. pylori may not be associated with laryngeal pathologies.
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Affiliation(s)
- Neenu Anna Joseph
- Department of ENT, Christian Medical College, Vellore, Tamil Nadu 632004 India
- St. John’s Hospital, Kattapana, Kerala India
| | - Suma Susan Mathews
- Department of ENT, Christian Medical College, Vellore, Tamil Nadu 632004 India
| | - Shalini Anandan
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu India
| | - Balaji Veeraraghavan
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu India
| | | | - Anna B. Pulimood
- Department of General Pathology, Christian Medical College, Vellore, Tamil Nadu India
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Zhang QQ, Xie M, Guo RX, Liu XH, Ma SJ, Chen YJ, Yang MJ, Shi YW, Ren XY, Luo HN. The effects of Helicobacter pylori eradication therapy on salivary pepsin concentration in patients with laryngopharyngeal reflux. Eur Arch Otorhinolaryngol 2022; 279:5289-5297. [PMID: 35798999 DOI: 10.1007/s00405-022-07439-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 05/06/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate the effect of Helicobacter pylori (HP) eradication therapy on salivary pepsin concentration in laryngopharyngeal reflux (LPR) patients with HP infection. MATERIALS AND METHODS A total of 477 patients with suspected LPR were enrolled from June 2020 to September 2021. Reflux symptom index, reflux finding score, the positive rates and disintegrations per minute values of HP infection detected by 14C urea breath test and salivary pepsin concentrations analyzed using enzyme-linked immunosorbent assay were compared in LPR patients and non-LPR patients with or without HP infection. HP-positive patients were treated with HP eradication therapy while HP-negative patients with PPI therapy. RESULTS The scores of nagging cough (0.88 vs. 0.50, P = 0.035), erythema or hyperemia (1.93 vs. 1.78, P = 0.035) and vocal fold edema (1.04 vs. 0.85, P = 0.025) were higher in the LPR (+) Hp (+) subgroup than in LPR (+) Hp (-) subgroup. The concentrations of salivary pepsin in the Hp (+) subgroup were higher than in the Hp (-) subgroup either in LPR patients (75.24 ng/ml vs. 61.39 ng/ml, P = 0.005) or the non-LPR patients (78.42 ng/ml vs. 48.96 ng/ml, P = 0.024). Compared to baseline (before treatment), scores of nagging cough (0.35 vs. 0.84, P = 0.019) and erythema or hyperemia (1.50 vs. 1.83, P = 0.039) and the concentrations of salivary pepsin (44.35 ng/ml vs. 74.15 ng/ml, P = 0.017) in LPR patients with HP infection decreased after HP treatment; yet, this was not observed for the LPR patients without HP infection treated with PPI only (P > 0.05). CONCLUSION HP infection may aggravate the symptoms and signs of LPR patients, partly by increasing their salivary pepsin concentration.
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Affiliation(s)
- Qing-Qing Zhang
- Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital Of Xi'an Jiao Tong University, Xi'an, 710004, China
| | - Meng Xie
- Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital Of Xi'an Jiao Tong University, Xi'an, 710004, China
| | - Rui-Xin Guo
- Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital Of Xi'an Jiao Tong University, Xi'an, 710004, China
| | - Xiao-Hong Liu
- Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital Of Xi'an Jiao Tong University, Xi'an, 710004, China
| | - Si-Jing Ma
- Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital Of Xi'an Jiao Tong University, Xi'an, 710004, China
| | - Yang-Juan Chen
- Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital Of Xi'an Jiao Tong University, Xi'an, 710004, China
| | - Min-Juan Yang
- Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital Of Xi'an Jiao Tong University, Xi'an, 710004, China
| | - Ye-Wen Shi
- Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital Of Xi'an Jiao Tong University, Xi'an, 710004, China
| | - Xiao-Yong Ren
- Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital Of Xi'an Jiao Tong University, Xi'an, 710004, China
| | - Hua-Nan Luo
- Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital Of Xi'an Jiao Tong University, Xi'an, 710004, China.
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Romanenko SG, Kryukov AI, Pronina NA, Pavlikhin OG, Yarovaya LA. [Screening for laryngeal disease in patients with gastroesophageal reflux disease]. Vestn Otorinolaringol 2022; 87:14-18. [PMID: 36580504 DOI: 10.17116/otorino20228706114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To improve the diagnosis of laryngeal disease in patients with gastroesophageal reflux disease (GERD). MATERIAL AND METHODS 171 patients (89 (52%) men, 82 (48%) women) with non-erosive (39 (23%) people) and erosive (132 (77%) people) forms of GERD were examined. None of the patients made active complaints about the condition of the larynx and pharynx. The examination included a questionnaire, examination by an otorhinolaryngologist, and videoendolaryngoscopy. RESULTS The survey revealed the presence of symptoms of otorhinolaryngological pathology in 74% of patients. Videolaryngoscopy revealed no laryngeal pathology in 55 (32%) patients, and signs of GERD-associated laryngitis were detected in 116 (68%) patients. The most common pathology was pachydermia in interarytenoid region - in 89 people, laryngeal granuloma was detected in 7 patients, leukoplakia - in 2 patients, chronic edematous polypous laryngitis - in 2 patients, benign laryngeal formations - in 9 patients. In patients with GERD (erosive and non-erosive forms), an asymptomatic course of chronic laryngitis associated with this pathology was observed in 44% of cases. In 52% of patients, pachydermia in interarytenoid region was diagnosed, of which every second had pronounced hyperplasia and folding of the mucous membrane in interarytenoid region, which must be differentiated from laryngeal cancer (in this case, patients should be under the dynamic supervision of an otorhinolaryngologist). Other precancerous formations of the larynx (granulomas and leukoplakia) were found in 5% of patients. Benign neoplasms of the larynx (polyps and cysts) were also detected in 5% of cases. CONCLUSIONS Despite the high frequency of detection of otorhinolaryngological diseases in the examined patients with gastroesophageal reflux disease, none of the patients presented complaints related to the pathology of the larynx, which indicates the need for active detection of this pathology in this category of patients by questioning, questioning, as well as examination by an otorhinolaryngologist.
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Affiliation(s)
- S G Romanenko
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - A I Kryukov
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia.,Pirogov Russian National Research Medical University, Moscow, Russia
| | - N A Pronina
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia.,Polyclinic No. 2 of Administrative Directorate of the President of the Russian Federation, Moscow, Russia
| | - O G Pavlikhin
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - L A Yarovaya
- Polyclinic No. 2 of Administrative Directorate of the President of the Russian Federation, Moscow, Russia
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Singh GB, Yvette War G, Shukla S, Kaur R, Malhotra S, Kumar S. The role of Helicobacter Pylori and laryngopharyngeal reflux in recurrent tonsillitis. Int J Pediatr Otorhinolaryngol 2020; 138:110376. [PMID: 33152967 DOI: 10.1016/j.ijporl.2020.110376] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 09/07/2020] [Accepted: 09/07/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To detect Helicobacter Pylori [HP] in tonsillar tissue of recurrent tonsillitis cases and assess the possible role of Laryngopharyngeal reflux [LPR] in tonsillar HP infection. METHODS A prospective study was done on the cited subject in a sample size of 50 paediatric patients [Age group: 6-18 years] suffering from recurrent tonsillitis. LPR was diagnosed by Reflux Symptom index [RSI] and Reflux Finding score [RFS]. A score of more than 7 and 13 was regarded as significant for RFS and RSI respectively. Patients with both scores significant were regarded to be suffering from LPR. Tonsillar specimen after tonsillectomy were subjected to urease test, histopathology [ Modified Giemsa Staining] and culture to detect HP. A minimum of two positive tests of the mentioned three were taken as gold standard to diagnose colonization of HP. Tabulated data was statistically analysed. RESULTS We recorded an incidence of 9% [18 cases] for LPR in recurrent tonsillitis. No case of HP colonization of tonsils was detected in this case series, even in patients of LPR. CONCLUSION We conclude that tonsils are not an extra gastric reservoir of HP. In addition, there is no aetiological relationship between recurrent tonsillitis and HP. And lastly, LPR is not a significant factor for colonization of tonsils by HP.
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Affiliation(s)
- Gautam Bir Singh
- Department of Otorhinolaryngology-Head & Neck Surgery, Lady Hardinge Medical College & Associated Hospitals, Shaheed Bhagat Singh Marg, New Delhi, 110001, India.
| | - Gabriella Yvette War
- Department of Otorhinolaryngology-Head & Neck Surgery, Lady Hardinge Medical College & Associated Hospitals, Shaheed Bhagat Singh Marg, New Delhi, 110001, India
| | - Shailja Shukla
- Department of Pathology, Lady Hardinge Medical College & Associated Hospitals, Shaheed Bhagat Singh Marg, New Delhi, 110001, India
| | - Ravinder Kaur
- Department of Microbiology, Lady Hardinge Medical College & Associated Hospitals, Shaheed Bhagat Singh Marg, New Delhi, 110001, India
| | - Sonali Malhotra
- Department of Otorhinolaryngology-Head & Neck Surgery, Lady Hardinge Medical College & Associated Hospitals, Shaheed Bhagat Singh Marg, New Delhi, 110001, India
| | - Sunil Kumar
- Department of Otorhinolaryngology-Head & Neck Surgery, Lady Hardinge Medical College & Associated Hospitals, Shaheed Bhagat Singh Marg, New Delhi, 110001, India
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Laryngopharyngeal Reflux and GERD: Correlation Between Reflux Symptom Index and Reflux Finding Score. Indian J Otolaryngol Head Neck Surg 2019; 71:684-688. [PMID: 31742042 DOI: 10.1007/s12070-018-1480-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 08/18/2018] [Indexed: 10/28/2022] Open
Abstract
To study the relationship between laryngopharyngeal reflux (LPR) and gastroesophageal reflux disease (GERD) using clinical scoring and endoscopy. Data was collected from a sample of 100 patients with GERD symptoms who presented to ENT out-patient department, for a duration of 2 years. Patients were evaluated using Reflux Symptom Index (RSI) questionnaire and Reflux Finding Score (RFS). All patients underwent videolaryngoscopy and upper gastrointestinal endoscopy. Patient with positive findings underwent treatment with proton pump inhibitors and were followed up for 3 months. Out of 100 patients, 23 had LPR, 19 had GERD, 40 had LPR + GERD, 18 were normal. Among the LPR group, the predominant symptoms were hoarseness of voice, globus sensation and heartburn. Majority of GERD group had globus sensation, dysphagia and heartburn as their predominant symptoms. On laryngoscopy, in both LPR and LPR + GERD group, most common finding was interarytenoid erythema and vocal cord edema. On esophagogastroduodenoscopy, in both GERD and LPR + GERD group, esophagitis was the most common finding. RSI value was highest in patients with LPR + GERD. RFS value was high in LPR group followed by groups of LPR + GERD and GERD. RSI and RFS are easily administered, highly reproducible, low cost clinical scoring symptom questionnaire which can identify the patients with LPR. 82.6% of LPR patients had significant RFS scoring but with no significant findings in OGD. This study also illustrates the importance of PPI therapy in LPR patients with no evidence of GERD.
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Jelavic B, Petricevic J, Marijanović I, Bevanda M. Helicobacter pylori in Otorhinolaryngology: Cause or Bystander. Eurasian J Med 2019; 51:196-202. [PMID: 31258363 DOI: 10.5152/eurasianjmed.2018.18192] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The bacteria Helicobacter pylori (H. pylori) have been identified in the extragastric tissues in the head and neck. The origin and pathogenicity of these bacteria in the head and neck are not known. Gastric reflux and nasal or oral routes are the possible modes of spread. In many sinonasal, pharyngeal, laryngeal, and middle ear disorders, laryngopharyngeal reflux has been identified as a contributing or causative factor. One possible mode by which laryngopharyngeal reflux may contribute is by seeding of the extragastric mucosa with H. pylori. The clinical significance of the discovery of H. pylori in extragastric tissues in the head and neck is unclear. There is no evidence of a pathologic or active role of H. pylori in otorhinolaryngological disorders. The suggestion that the sinonasal cavities and pharynx may serve as a reservoir for H. pylori and that reinfection of the stomach occurs after eradication therapy awaits further studies for confirmation. No connection was observed between H. pylori found in the stomach and H. pylori found in the head and neck. Also, these bacteria, found in the head and neck tissues, may be accidental or innocent bystanders that do not affect the pathways of otolaryngological and gastroduodenal diseases. This review examines the evidence for a possible relationship of H. pylori with otorhinolaryngological diseases.
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Affiliation(s)
- Boris Jelavic
- Department of Otorhinolaryngology, University Hospital Mostar, Mostar, Bosnia and Herzegovina.,School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina
| | - Josko Petricevic
- Department of Pathology, Cytology and Forensic Medicine, University Hospital Mostar, Mostar, Bosnia and Herzegovina.,School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina
| | - Inga Marijanović
- Department of Oncology, University Hospital Mostar, Mostar, Bosnia and Herzegovina.,School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina
| | - Milenko Bevanda
- Department of Gastroenterology, University Hospital Mostar, Mostar, Bosnia and Herzegovina.,School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina
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Gastroesophageal and Laryngopharyngeal Reflux Associated With Laryngeal Malignancy: A Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol 2019; 17:1253-1264.e5. [PMID: 30366155 DOI: 10.1016/j.cgh.2018.10.028] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 10/04/2018] [Accepted: 10/08/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Gastric reflux may lead to chronic mucosal inflammation and contribute to development of laryngeal malignancies, although there is controversy over this association. We performed a systematic review and meta-analysis to assess this relationship and determine the risk of laryngeal malignancy in patients with reflux disease. METHODS We performed a systematic review and meta-analysis, searching MEDLINE, EMBASE, and Web of Science databases from 1900 through April 9, 2018, for observational studies of adults reporting associations between gastroesophageal reflux disease (GERD) and/or laryngopharyngeal reflux and the risk of having or developing laryngeal malignancies. An itemized assessment of the risk of bias was conducted for each study that met inclusion criteria. The meta-analysis was performed using the Mantel-Haenszel method with random effects to account for heterogeneity. We performed subgroup analyses to determine the effect of reflux type, study design, diagnostic method, and confounding variables on the overall risk. RESULTS Of the 957 studies that were identified during systematic review, 18 case-control studies met the criteria for analysis. Our meta-analysis showed that reflux disease significantly increased the risk of laryngeal malignancy (odds ratio, 2.47; 95% CI, 1.90-3.21; P < .00001; I2 = 94%). This association remained when controlling for patient smoking and drinking (odds ratio, 2.07; 95% CI, 1.26-3.41). There was no statistically significant difference in risk of laryngeal malignancies between patients with GERD vs laryngopharyngeal reflux (P = .44). CONCLUSIONS In a systematic review and meta-analysis, we found a significant association between reflux disease and the presence of laryngeal malignancy. Prospective studies should be performed to examine this relationship.
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10
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Li’e C, Juan C, Dongying J, Guiling F, Tihua Z, Yanfei W. The role of environmental tobacco exposure and Helicobacter pylori infection in the risk of chronic tonsillitis in children. SAO PAULO MED J 2017; 135:29-33. [PMID: 28380174 PMCID: PMC9969719 DOI: 10.1590/1516-3180.2016.023602102016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 10/02/2016] [Indexed: 11/21/2022] Open
Abstract
CONTEXT AND OBJECTIVE: Helicobacter pylori (H. pylori) is a chronic infectious pathogen with high prevalence. This study investigated the interaction between environmental tobacco exposure and H. pylori infection on the incidence of chronic tonsillitis in Chinese children. DESIGN AND SETTING: Cross-sectional study performed in an outpatient clinic in China. METHODS: Pediatric patients with chronic tonsillitis were enrolled. H. pylori infection was determined according to the presence of H. pylori CagA IgG antibodies. Serum cotinine levels and environmental tobacco smoke (ETS) exposure were determined for all participants. RESULTS: There was no significant difference in H. pylori infection between the children with chronic tonsillitis and children free of disease, but there was a significant difference in ETS between the two groups (P = 0.011). We next studied the association between ETS and chronic tonsillitis based on H. pylori infection status. In the patients with H. pylori infection, there was a significant difference in ETS distribution between the chronic tonsillitis and control groups (P = 0.022). Taking the participants without ETS as the reference, multivariate logistic regression analysis showed that those with high ETS had higher susceptibility to chronic tonsillitis (adjusted OR = 2.33; 95% CI: 1.67-3.25; adjusted P < 0.001). However, among those without H. pylori infection, ETS did not predispose towards chronic tonsillitis. CONCLUSION: Our findings suggest that tobacco exposure should be a putative mediator risk factor to chronic tonsillitis among children with H. pylori infection.
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Affiliation(s)
- Chen Li’e
- MD. Attending Physician, Department of Otorhinolaryngology, Binzhou Medical University Hospital, Binzhou, Shandong, China.
| | - Che Juan
- MD. Attending Physician, Department of Otorhinolaryngology, Binzhou Medical University Hospital, Binzhou, Shandong, China.
| | - Jiang Dongying
- MD. Attending Physician, Department of Otorhinolaryngology, Binzhou Medical University Hospital, Binzhou, Shandong, China.
| | - Feng Guiling
- MD. Attending Physician, Department of Otorhinolaryngology, Binzhou Medical University Hospital, Binzhou, Shandong, China.
| | - Zheng Tihua
- MD. Attending Physician, College of Special Education, Binzhou Medical University, Yantai, Shandong, China.
| | - Wang Yanfei
- MD. Attending Physician, Department of Otorhinolaryngology, Binzhou Medical University Hospital, Binzhou, Shandong, China.
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11
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Campbell R, Kilty SJ, Hutton B, Bonaparte JP. The Role of Helicobacter pylori in Laryngopharyngeal Reflux. Otolaryngol Head Neck Surg 2016; 156:255-262. [PMID: 27803078 DOI: 10.1177/0194599816676052] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Objective The primary objective was to determine the prevalence of Helicobacter pylori among patients with laryngopharyngeal reflux. The secondary objective was determining if H pylori eradication leads to greater symptom improvement in patients with laryngopharyngeal reflux as compared with standard proton pump inhibitor therapy alone. Data Sources EMBASE, Cumulative Index to Nursing and Allied Health Literature, MEDLINE, World Health Organization International Clinical Trials Registry Platform, European Union Clinical Trials Register, Cochrane Library databases of clinical trials, and ClinicalTrials.gov. Review Methods A systematic review was performed of studies assessing the diagnosis or treatment of H pylori among patients with laryngopharyngeal reflux. Randomized controlled trials, cohort studies, case-control studies, and case series were included. A meta-analysis of prevalence data and assessment of heterogeneity was performed on relevant studies. Results Fourteen studies were analyzed in the review, with 13 eligible for the meta-analysis. We determined that the prevalence of H pylori among patients with laryngopharyngeal reflux was 43.9% (95% confidence interval, 32.1-56.5). The heterogeneity of studies was high, with an overall I2 value of 92.3%. We were unable to quantitatively assess findings for our secondary outcome, since H pylori identification and treatment were not the primary focus of the majority of studies. Conclusion There is a high rate of H pylori infection among patients with laryngopharyngeal reflux. The infection rate in North America and Western Europe has not been adequately studied. There is insufficient evidence to make a recommendation regarding the testing and treatment of H pylori infection among patients with laryngopharyngeal reflux.
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Affiliation(s)
- Ross Campbell
- 1 Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, Ottawa, Canada
| | - Shaun J Kilty
- 1 Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, Ottawa, Canada
| | - Brian Hutton
- 2 Knowledge Synthesis Group, Centre for Practice-Changing Research, Ottawa Hospital Research Institute, Ottawa, Canada.,3 Public Health and Preventive Medicine, School of Epidemiology, University of Ottawa, Ottawa, Canada
| | - James P Bonaparte
- 1 Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, Ottawa, Canada
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12
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Barakat G, Nabiel Y, Ali O, El-Nady G, Musaad A, El-Sharkawy A. UreA and cagA genes of Helicobacter pylori in Egyptian patients with laryngeal squamous cell carcinoma and benign laryngeal polyps: a cohort study. Eur Arch Otorhinolaryngol 2016; 273:3243-8. [PMID: 27225283 DOI: 10.1007/s00405-016-4114-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 05/20/2016] [Indexed: 02/06/2023]
Abstract
This work aims to estimate the prevalence of Helicobacter pylori ureA gene and evaluate cagA gene-positive strains in both patients of laryngeal squamous cell carcinoma (LSCC) and those with benign laryngeal polyps. This study included 49 patients confirmed pathologically to have LSCC and 15 patients with benign laryngeal polyps over a period from June 2013 to March 2015. Samples of laryngeal tissue were collected during direct laryngoscope under general anesthesia to be pathologically evaluated followed by analysis for H. pylori detection. Each laryngeal tissue sample was divided into three parts; one for bacteriological examination, the second for pathological examination and the third for PCR to detect both ureA and cagA genes. Out of 49 LSCC samples, 31 (64.6 %) was positive for ureA by PCR. Out of them, 29 samples (93.5 %) were cagA positive. Only three cases (20 %) of the benign laryngeal polyp were ureA positive by PCR and one of them was cagA positive by PCR. By the bacteriological culture, only eight samples (25.8 %) gave growth. All of them were ureA positive and only seven of them were cagA positive. There was a significant association between presence of H. pylori and LSCC as compared to benign laryngeal polyp which may contribute in the pathogenesis of laryngeal carcinoma. These results should be confirmed by further studies over larger number of cases.
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Affiliation(s)
- Ghada Barakat
- Medical Microbiology and Immunology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
| | - Yasmin Nabiel
- Medical Microbiology and Immunology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Omima Ali
- Medical Microbiology and Immunology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Ghada El-Nady
- Medical Microbiology and Immunology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Ahmed Musaad
- Otorhinolarngology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Asser El-Sharkawy
- Otorhinolarngology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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13
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The Role of Pepsin in LPR: Will It Change Our Diagnostic and Therapeutic Approach to the Disease? CURRENT OTORHINOLARYNGOLOGY REPORTS 2016. [DOI: 10.1007/s40136-016-0106-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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14
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Morand GB, Fellmann J, Laske RD, Weisert JU, Soltermann A, Zbinden R, Probst R, Huber GF. Detection ofHelicobacter pyloriin patients with head and neck cancer: Results from a prospective comparative study combining serology, polymerase chain reaction, and rapid urease test. Head Neck 2015; 38:769-74. [DOI: 10.1002/hed.23958] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2014] [Indexed: 12/14/2022] Open
Affiliation(s)
- Grégoire B. Morand
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital Zurich; Switzerland
| | - Jonas Fellmann
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital Zurich; Switzerland
| | - Roman D. Laske
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital Zurich; Switzerland
| | - Jan U. Weisert
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital Zurich; Switzerland
| | - Alex Soltermann
- Institute of Surgical Pathology, University Hospital Zurich; Switzerland
| | - Reinhard Zbinden
- Institute of Medical Microbiology, University of Zurich; Switzerland
| | - Rudolf Probst
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital Zurich; Switzerland
| | - Gerhard F. Huber
- Department of Otorhinolaryngology, Head and Neck Surgery; University Hospital Zurich; Switzerland
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15
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Bock JM, Howell AB, Johnston N, Kresty LA, Lew D. Upper esophageal and pharyngeal cancers. Ann N Y Acad Sci 2015; 1325:49-56. [PMID: 25266014 DOI: 10.1111/nyas.12519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The following, from the 12th OESO World Conference: Cancers of the Esophagus, includes commentaries on laryngopharyngeal reflux as a risk factor for laryngeal cancer; the role of pepsin in laryngopharyngeal neoplasia; natural fruit and vegetable compounds for the prevention and treatment of pharyngeal and esophageal cancers; and evaluation of cranberry constituents as inhibitors of esophageal adenocarcinoma utilizing in vitro assay and in vivo models.
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Affiliation(s)
- Jonathan M Bock
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin
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16
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Yilmaz I, Erkul E, Berber U, Kucukodaci Z, Narli G, Haholu A, Demirel D. The presence of Helicobacter pylori in laryngeal squamous cell carcinoma. Eur Arch Otorhinolaryngol 2015; 273:761-5. [PMID: 25721196 DOI: 10.1007/s00405-015-3566-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Accepted: 02/16/2015] [Indexed: 02/07/2023]
Abstract
A definitive relationship between Helicobacter pylori (HP) and upper respiratory tract disorders has not been established. In this case-control study, we investigated the relationship between HP and laryngeal carcinoma by real-time PCR method in Turkey. 74 subjects were enrolled from patients who were admitted to the Otolaryngology Department. Formalin-fixed-paraffin-embedded tissue samples with laryngeal cancer were used and all samples were evaluated by real-time PCR method. Our study population included 72 males and 2 females with a mean age range of 62.7 years. Helicobacter Pylori was detected in only one case. The positive case was also investigated with histopathologic evaluation and HP immunohistochemistry. However, we could not detect HP in this case with both methods. This study revealed that HP might not contribute to the pathogenesis of laryngeal carcinoma. A definitive relationship between HP and upper respiratory tract disorders has not been established.
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Affiliation(s)
- Ismail Yilmaz
- Department of Pathology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey
| | - E Erkul
- Department of Otorhinolaryngology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey.
| | - U Berber
- Department of Pathology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey
| | - Z Kucukodaci
- Department of Pathology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey
| | - G Narli
- Department of Pathology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey
| | - A Haholu
- Department of Pathology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey
| | - D Demirel
- Department of Pathology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey
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17
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Zhang D, Zhou J, Chen B, Zhou L, Tao L. Gastroesophageal reflux and carcinoma of larynx or pharynx: a meta-analysis. Acta Otolaryngol 2014; 134:982-9. [PMID: 25131391 DOI: 10.3109/00016489.2014.927592] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
CONCLUSION The meta-analysis supported the proposition that the prevalence of gastroesophageal reflux disease (GERD) was associated with laryngeal cancer, particularly in the hospital-based control group and diagnosed by esophagogastroduodenoscopy (EGD) or esophageal pH monitoring. However, no significant association was found between GERD and pharyngeal carcinoma. OBJECTIVES A number of studies have been conducted to investigate the relationship between gastroesophageal reflux and laryngeal or pharyngeal carcinoma. The conclusions are still debated. METHODS We conducted a systematic review of studies associated with the prevalence of GERD in laryngeal or pharyngeal cancer, published up to November 2013.Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated using random effects models or fixed effects models, according to heterogeneity I(2). RESULTS Ten studies were included in this meta-analysis. On average, GERD was significantly higher in the tumor tissue of the study group compared with normal tissue of the control group (OR = 2.17, 95% CI = 1.50, 3.14; random effects analysis). The pooled ORs for laryngeal carcinoma were 2.21 (95% CI = 1.53-3.19; I(2) = 97, random effects model) and 3.76 (95% CI = 0.21-67.48; I(2) = 94, random effects model) for pharyngeal carcinoma.
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Affiliation(s)
- Duo Zhang
- Department of Otolaryngology-HNS, Eye, Ear, Nose and Throat Hospital, Fudan University School of Medicine , Shanghai , China
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18
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Roubaud Baudron C, Franceschi F, Salles N, Gasbarrini A. Extragastric diseases and Helicobacter pylori. Helicobacter 2013; 18 Suppl 1:44-51. [PMID: 24011245 DOI: 10.1111/hel.12077] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In the last year, several diseases from outside of the gastrointestinal tract have been associated with Helicobacter pylori infection. Indeed, this bacterium produces a low-grade inflammatory state, induces molecular mimicry mechanisms, and interferes with the absorbance of nutrients and drugs possibly influencing the occurrence or the evolution of many diseases. In addition to its role in some hematologic conditions, such as immune thrombocytopenic purpura, idiopathic sideropenic anemia, and vitamin B12 deficiency, which were included in the current guidelines, several other conditions such as cardiovascular diseases, diabetes mellitus, hepatobiliary diseases, and neurologic disorders have also shown promising results.
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Affiliation(s)
- Claire Roubaud Baudron
- Université de Bordeaux, Laboratoire de Bactériologie, Bordeaux, France; Pôle de Gérontologie Clinique, Bordeaux, France; INSERM U853, Bordeaux, France
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19
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Siupsinskiene N, Jurgutaviciute V, Katutiene I, Janciauskas D, Vaitkus S, Adamonis K. Helicobacter pylori infection in laryngeal diseases. Eur Arch Otorhinolaryngol 2013; 270:2283-8. [PMID: 23572292 DOI: 10.1007/s00405-013-2475-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2013] [Accepted: 03/26/2013] [Indexed: 12/26/2022]
Abstract
Clinical studies have shown that Helicobacter pylori can be found not only in the mucosa of the stomach, but in the pharyngeal and laryngeal regions as well. The aim of this prospective case-control study was to identify H. pylori infection in the biopsy material from the larynx of the patients suffering from benign laryngeal diseases (vocal fold polyps, laryngitis) and laryngeal cancer and to investigate the possible relationships between the laryngeal H. pylori and patients' socio-demographic data and laryngopharyngeal reflux. The results of the biopsy material from 67 adult patients treated for benign laryngeal diseases and laryngeal cancer and 11 individuals of the control group revealed that H. pylori infection could be identified in more than one-third of the patients. In the majority of cases H. pylori was found in the patients with chronic laryngitis (45.5%) and laryngeal cancer (46.2%). The findings of these sub-groups significantly differed from those of the control group (9.1%) (p < 0.05). No significant relationships between H. pylori infection found in the laryngeal region and patients' demographic data, their unhealthy habits and reflux-related symptoms or signs were obtained. It could be concluded that H. pylori can colonize in the larynx of patients with benign laryngeal diseases and laryngeal cancer. To clarify the role of H. pylori as a risk factor for laryngeal diseases further research is needed.
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Affiliation(s)
- Nora Siupsinskiene
- Department of Otolaryngology, Academy of Medicine, Lithuanian University of Health Sciences Hospital, Kaunas Clinic, Eiveniu 2, Kaunas, 50009, Lithuania.
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