Gintarė Petreikytė1, Žygimantas Mickus1, Evaldas Padervinskis2
1Lithuanian University of Health Sciences, Medical Academy, Faculty of Medicine, Kaunas, Lithuania
2Lithuanian University of Health Sciences Kauno Klinikos, Department of Otorhinolaryngology, Kaunas, Lithuania
Background. It is known that the development of laryngeal squamous cell carcinoma (LSCC) is influenced by smoking, alcohol consumption and other factors. As the prevalence of gastroesophageal reflux disease (GERD) and LSCC increases, there is more and more discussion in the world about the negative effects of long-term gastric irritation on laryngeal mucosa. Accordingly, novel data presents that GERD can be an independent etiological risk factor of LSCC.
Aim: to evaluate the characteristics of laryngeal squamous cell carcinoma and gastroesophageal reflux disease and possible relationship between these pathologies.
Methods. The search for literature was performed in online databases using the following keywords and their combinations: gastroesophageal reflux disease, laryngopharyngeal reflux, helicobacter pylori, laryngeal squamous cell carcinoma, laryngeal malignancy, laryngeal mucosa. 10 main publications were included. Descriptive analysis was used to analyze the literature.
Results. H. pylori colonization and long-term irritation of the larynx with gastric content can cause inflammatory damage and carcinogenic progression of the epithelium. Patients diagnosed with reflux are 2.47 times more likely to have laryngeal cancer and the association remains when controlling for other risk factors, such as smoking and alcohol consumption. Additionally, patients, who previously underwent antireflux surgery, have a reduced risk of laryngeal cancer.
Conclusions. GERD can be associated with the development of LSCC, independently from smoking and alcohol consumption. Long-term irritation with gastric acid, H. pylori colonization can cause microscopic and macroscopic changes in the laryngeal mucosa, which can induce chronic inflammation and oncological progression.
Keywords: laryngeal squamous cell carcinoma, laryngeal cancer, gastroesophageal reflux, laryngopharyngeal reflux, h. pylori