喉癌患者并发咽喉反流的初步观察

Research on the association of the laryngeal carcinoma and laryngopharyngeal reflux

目的：探讨喉癌与咽喉反流的关系。方法对31例喉癌与76例对照组（其中36例反流症状和反流体征量表均阴性，40例反流症状指数和/或反流体征评分量表阳性）的一般情况及pH监测参数进行统计学分析。结果喉癌组患者吸烟率80.6％（25/31），与阴性对照组36.1％（13/36）差异有统计学意义（ P＜0.0167），与阳性对照组50.0％（20/40）差异无统计学意义（ P＞0.0167）。喉癌组饮酒率71.0％（22/31），与阴性组36.1％（13/36）差异有统计学意义（ P＜0.0167），与阳性组65.0％（26/40）差异无统计学意义（P＞0.0167）。咽喉反流阳性率，喉癌组、阴性对照和阳性对照组分别为74.2％（23/31）、16.7％（6/36）和52.5％（21/40），食管反流阳性率分别为71.0％（22/31）、52.8％（19/36）和75.0％（30/40）。三组间的咽部阳性率差异有统计学意义（P＜0.05），其中喉癌组与阴性对照组差异有统计学意义（ P ＜0.0167），喉癌组与阳性对照组差异无统计学意义（ P ＞0.0167）。三组间食管阳性率差异无统计学意义（ P＞0.05）。 pH监测参数发现，喉癌组与阴性对照组的咽喉反流次数、直立位咽喉反流次数、咽喉反流总时间、上探头pH＜4时间百分比、长反流次数、咽部DeMeester评分差异均有统计学意义（ P值均＜0.0167），其中喉癌组与阳性对照组的上述指标差异均无统计学意义（ P值均＞0.0167）。结论喉癌患者中咽喉反流阳性率很高，但是咽喉反流阳性喉癌患者中吸烟和/或饮酒的比率也很高，咽喉反流是否为喉癌发病的危险因素，有待继续研究。

Objective The objective of this study is to investigate the association between laryngeal carcinoma and laryngopharyngeal reflux .Methods This was a case-control study with 31 laryngeal cancer patients who had undergone 24-hour ambulatory double pH monitoring and 76 in the control group which were divided into negative group （ 36 patients ） and positive group （ 40 patients ） by the score of RSI （ reflux symptom index） and RFI （ reflux findings index ） scale.The results of reflux and parameters of 24-hour ambulatory double pH monitoring among the three groups were statistically analysed .Results The smoking rate of 80.6%（25/31） in laryngeal carcinoma group was significantly higher than that of （36.1%, P＆lt;0.0167） in the negative group while it did not vary in laryngeal carcinoma group and the positive group （65.0%, P＆gt;0.0167）.The drinking rate of 71.0% （22/31） in laryngeal carcinoma group was higher than that of （36.1%, P＆lt;0.0167） in the negative group whereas there was no significant difference between laryngeal carcinoma group and positive group （50.0%, P＆gt;0.0167）.The positive rate of laryngopharyngeal reflux in laryngeal carcinoma group , the positive group, the negative group were 74.2%（23/31）, 16.7%（6/36） and 52.5%（21/40） respectively, which was significantly different （P＆lt;0.05）.The positive rate of gastroesophageal reflux in the three groups above were 71.0% （22/31）, 52.8% （19/36） and 75.0%（30/40）, which had no significant difference （ P＆gt;0.05）.The positive rate of laryngopharyngeal reflux differed in laryngeal carcinoma group and the negative group （P＆lt;0.0167） while did not differ in laryngeal carcinoma group and the positive group （ P ＆gt;0.0167）.In the results of 24-hour ambulatory double pH monitoring , there was significant difference in the total and upright reflux number , the total reflux time , the percent times for the pH falling below 4, total reflux number which lasted more than 5 minutes and＆amp;nbsp;DeMeester Scores .Conclusions The positive rate of laryngopharyngeal reflux in laryngeal carcinoma group was very high while the drinking and smoking rate were also high .Therefore whether the laryngopharyngeal reflux is a risk factor of the laryngeal carcinoma ,it needs further research .