[The expression and significance of pepsin in laryngeal carcinoma].
OBJECTIVE
To evaluate the relationship between pepsin induced by laryngopharyngeal reflux and laryngeal carcinoma.


METHODS
Patients with vocal cord leukoplakia(n=18) and laryngeal carcinoma(n=21) encountered in Nanfang Hospital between December 2012 and April 2014 were included and sixteen healthy volunteers were recruited as control. Laryngeal biopsy specimens were taken from the patients with laryngeal carcinoma, or vocal cord leukoplakia and control subjects for the immunohistochemical study of pepsin. The correlation between pepsin expression and reflux events of 24 hour multichannel intraluminal impedance-pH monitoring (MII-pH) was analyzed.


RESULTS
The patients with laryngeal carcinoma showed the highest expression of pepsin, followed by the patients with vocal cord leukoplakia and control subjects, with significant difference among the three groups (in strong positive expression, the constituent ratio of each group are 0/16、1/18 and 4/21, P<0.01). The presence of pepsin was associated with upright and total laryngopharyngeal acid reflux (P<0.05), including acid reflux episodes, the percentage of times that the pH was below four, the percentages of acid reflux time and average acid removal time. There was a significant correlation between the pepsin level and the esophageal acid reflux parameters (P<0.05) except supine the percentage of time that the pH was below four.


CONCLUSIONS
Pepsin expression in laryngeal tissue increases in patients with vocal cord leukoplakia and laryngeal carcinoma, contributing to the development of laryngopharyngeal carcinogenesis.
Department of Otorhinolaryngology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
J J
JJ
Tan
Department of Otorhinolaryngology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
L
L
Wang
Department of Otorhinolaryngology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Z F
ZF
Huang
Department of Otorhinolaryngology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Y F
YF
Li
Department of Otorhinolaryngology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
W D
WD
Tian
Department of Otorhinolaryngology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
X
X
Liu
Department of Otorhinolaryngology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
F F
FF
Zeng
Department of Otorhinolaryngology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
X P
XP
Li
D002277:Carcinoma / Q000209:etiology / Q000378:metabolism*; D016022:Case-Control Studies; D005764:Gastroesophageal Reflux / Q000378:metabolism; D006801:Humans; D007822:Laryngeal Neoplasms / Q000209:etiology / Q000378:metabolism*; D057045:Laryngopharyngeal Reflux / Q000150:complications / Q000378:metabolism*; D007830:Larynx / Q000378:metabolism; D007971:Leukoplakia / Q000150:complications / Q000378:metabolism; D010434:Pepsin A / Q000378:metabolism*
D010434:Pepsin A