Characterization of laryngopharyngeal reflux in patients with premalignant or early carcinomas of the larynx.
BACKGROUND
An association between laryngopharyngeal reflux (LPR) and laryngeal carcinoma has been suggested, but remains unproven. The current pilot study was performed to determine the incidence of LPR among patients with early laryngeal carcinomas or dysplasia and to examine the associations between levels of LPR and histologic stage, smoking status, the symptom of heartburn, and body position during reflux episodes.


METHODS
Behavioral and 24 hour pH monitoring data were prospectively acquired and analyzed for 40 previously untreated adults with dysplasia, T1 or T2 laryngeal carcinomas.


RESULTS
Eighty-five percent of patients had LPR. No significant association was shown between the level of LPR and histologic stage or smoking status. Heartburn did not predict LPR. The incidence of LPR in the upright body position was 91%, compared with 9% in the supine position, among patients with LPR.


CONCLUSIONS
When compared to available normative data, the current findings show a high incidence of LPR in patients with premalignant and early laryngeal cancer. These findings highlight the need for a matched-control study evaluating LPR as a potential predisposing factor for laryngeal carcinoma.
Lewin
Jan S
JS
Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030-1515, USA. jlewin@mail.mdanderson.org
Gillenwater
Ann M
AM
Garrett
J David
JD
Bishop-Leone
Julie K
JK
Nguyen
Dominic D
DD
Callender
David L
DL
Ayers
Gregory D
GD
Myers
Jeffrey N
JN
D002277:Carcinoma / Q000150:complications*; D005260:Female; D005764:Gastroesophageal Reflux / Q000209:etiology*; D006356:Heartburn / Q000150:complications; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007822:Laryngeal Neoplasms / Q000150:complications*; D007830:Larynx / Q000473:pathology; D008297:Male; D010614:Pharynx; D010865:Pilot Projects; D011187:Posture; D011230:Precancerous Conditions / Q000150:complications; D012907:Smoking