胃食管反流在喉癌及癌前病变中的临床意义

Clinical significance and research progress of gastroesophageal reflux in laryngeal carcinoma and preneoplastic conditions

喉癌是耳鼻咽喉头颈外科最常见的恶性肿瘤之一，其发病率目前有明显增长的趋势。由于头颈部解剖结构复杂并且病变发生区域相对隐蔽，临床症状明显时多已为中晚期，此时患者预后较差，生存质量下降明显，因此早期发现、早期诊断和治疗是提高喉癌整体疗效以及患者生活质量的关键所在。研究发现反流性疾病与喉癌及癌前病变的发生具有十分密切的联系，24小时pH监测显示83％的喉咽癌及喉癌患者存在咽喉反流，而对于喉癌前病变，有研究显示抑酸治疗可产生十分明显的改善作用。因此，抗反流治疗在喉癌及癌前病变诊疗体系中扮演着十分重要的作用。本文对反流胜疾病及其对于喉癌及癌前病变的影响及针对治疗方式的指导做一综述。

Laryngeal carcinoma is one of the most common malignancies in head and neck surgery, and its morbidity is obviously increasing at present. The anatomical structure of the head and neck is complex and the area of the lesion is relatively hidden, the clinical symptoms are obvious in the middle and late stage. At this time, the prognosis is poor and the quality of life declines obviously. Therefore, early detection, early diagnosis and treatment is the key to improve the overall efficacy of laryngeal cancer and the quality of life of patients. Study found that laryngeal cancer and preneoplastic conditions are closely related with reflux disease. 24h PH monitoring showed that 83% of laryngitis and laryngeal carcinoma patients with laryngopharygeal reflux. For preneoplastic conditions, studies have shown that acid suppression treatment can produce a very significant improvement. Therefore, anti-reflux therapy plays a very important role in diagnosis and treatment of laryngeal carcinoma and preneoplastic conditions.