Clin Exp Otorhinolaryngol.  2021 May;14(2):159-168. 10.21053/ceo.2020.00465.

Pepsin and Laryngeal and Hypopharyngeal Carcinomas

Affiliations
  • 1Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
  • 2Department of Otolaryngology, The First People’s Hospital of Huzhou City, Zhejiang, China

Abstract

Laryngeal and hypopharyngeal carcinomas are common malignant tumors of the head and neck, and the incidence of both is increasing. Laryngopharyngeal reflux refers to the retrograde flow of gastric contents into the larynx, oropharynx, and/or nasopharynx. It remains controversial whether laryngopharyngeal reflux is a risk factor for laryngeal and hypopharyngeal cancers. The refluxing substances mainly include hydrochloric acid, pepsin, and occasionally bile acids and bile salts, as well as bacteria that colonize the gastrointestinal tract. Loss of epithelium in the mucous membrane of the larynx and hypopharynx is thought to be caused by pepsin. Here, we review the relationships between laryngopharyngeal reflux and both laryngeal and hypopharyngeal carcinomas, as well as the significance of pepsin, methods of clinical detection, and the mechanism of carcinogenesis.

Keyword

Pepsin; Laryngopharyngeal Reflux; Laryngeal Carcinoma; Hypopharyngeal Carcinoma

Figure

  • Fig. 1. Diagram illustrating the role of pepsin in laryngeal and hypopharyngeal epithelial damage and tumorigenesis. H+ , hydrogen; miRNA, microRNA; KRT, keratin.


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