Abstract
Purpose
The aim of the study was to survey the association between prevalence of acid-related inflammation in the upper digestive tract and laryngeal cancer.
Materials and Methods
A case-control study was done in an otolaryngology ward at an academic university. Totally, 65 patients with laryngeal cancer and 65 cancer-free matched controls underwent esophagogastroduodenoscopy, and endoscopic findings were collected.
Results
In the case group, positive endoscopic findings were significantly higher than the control group (87.7% vs 58.5%; P < .001). Laryngeal cancer patients had erosive esophagitis, and gastritis ± other findings more than the control group (48 vs 29 cases) and the difference was statistically significant.
Conclusion
The difference between endoscopic findings in cases and controls was statistically significant. Severe inflammation and erosion existed in patients with laryngeal cancer that could be due to increased acid secretion. Our study supported the hypothesis that gastric acid and pepsin play a role in laryngeal cancer.
1
Introduction
Laryngeal cancer is one of the more common cancers in human beings. Factors that correlate with it include tobacco use, alcohol abuse, or a sibling with head and neck cancer. In addition, there is an association between laryngeal cancer and the presence of human papilloma virus, previous radiotherapy, previous head and neck cancer, and chemical carcinogens . Some studies have investigated role of Helicobacter pylori in laryngeal cancer . Although the relationship is not proven, acid pepsin diseases is regarded as a risk factor for laryngeal carcinoma.
Some studies have investigated role of acid reflux in laryngeal carcinoma and other studies have suggested other reflux components—bile (alkaline) and chlorhydro-peptic components in particular—as possible risk factors of laryngeal cancer .
None of the published studies have compared gastrointestinal (GI) endoscopic findings between patients with laryngeal carcinoma and cancer-free controls.
Our study evaluated GI endoscopic findings related to acid pepsin diseases such as inflammation, erosion, and ulcer between the 2 groups.
2
Materials and methods
Totally, 65 patients who had undergone laryngoscopy and biopsy with the definite diagnosis of squamous cell carcinoma (SCC) as well as those who had undergone total or partial laryngectomy between May 2006 and February 2008 at academic hospitals affiliated to Tabriz University of Medical Sciences (Iran) were investigated. These patients underwent esophagogastroduodenoscopy (EGD), and endoscopic findings were collected.
The control group (65 patients) consisted of hospitalized patients with anemia or other illnesses not associated with HP. They did not have signs of laryngeal cancer in medical history and laryngoscopy. These controls, similar to the case group, underwent EGD, and endoscopic findings were collected. A complete medical history including demographic data such as age and sex, cigarette smoking, and alcohol was obtained from each patient.
Clinical characteristics and laboratory variables were compared by independent-sample t test, χ 2 test, and Fisher exact test. A P value of less than .05 was considered statistically significant. All analyses were performed using the Statistical Package for the Social Science software (SPSS, SPSS Inc, Chicago, IL).
2
Materials and methods
Totally, 65 patients who had undergone laryngoscopy and biopsy with the definite diagnosis of squamous cell carcinoma (SCC) as well as those who had undergone total or partial laryngectomy between May 2006 and February 2008 at academic hospitals affiliated to Tabriz University of Medical Sciences (Iran) were investigated. These patients underwent esophagogastroduodenoscopy (EGD), and endoscopic findings were collected.
The control group (65 patients) consisted of hospitalized patients with anemia or other illnesses not associated with HP. They did not have signs of laryngeal cancer in medical history and laryngoscopy. These controls, similar to the case group, underwent EGD, and endoscopic findings were collected. A complete medical history including demographic data such as age and sex, cigarette smoking, and alcohol was obtained from each patient.
Clinical characteristics and laboratory variables were compared by independent-sample t test, χ 2 test, and Fisher exact test. A P value of less than .05 was considered statistically significant. All analyses were performed using the Statistical Package for the Social Science software (SPSS, SPSS Inc, Chicago, IL).
3
Results
Our case group included 63 males and 2 females with a mean age of 61.75 ± 7.70 years. The control group consisted of 63 males and 2 females with a mean age of 61.66 ± 7.62 years.
The prevalence of smoking and alcohol consumption was 78.5% and 29.2% in the laryngeal cancer group and 73.8% and 26.2% in the control group, respectively. The characteristics of the case and the control group are presented in Table 1 . The cases and the controls were matched in terms of age, sex, amount, and duration of tobacco and alcohol consumption and did not have any significant differences.
| Patient characteristic | With laryngeal cancer | Without laryngeal cancer | P |
|---|---|---|---|
| Mean age ± SD (y) | 61.75 ± 7.70 | 61.66 ± 7.62 | .945 |
| Men | 63 | 63 | 1 |
| Tobacco use | 51 (78.5%) | 48 (73.8%) | .537 |
| Alcohol use | 19 (29.2%) | 17 (26.2%) | .695 |
| Other risk factors | – | – | – |
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