Narrow-band imaging combined with salivary pepsin to diagnose patients with laryngopharyngeal reflux

Abstract

Background

Laryngopharyngeal reflux (LPR) is a prevalent disease in the ENT outpatient department. Methods of LPR diagnosis differ much. Narrow-band imaging (NBI) and Salivary pepsin-level measurements have been considered as totally new ways for the diagnosis of LPR in recent years.

Aim

We aimed to identify the specific manifestation of LPR and assess the correlation between NBI views and pepsin levels in LPR diagnosing.

Materials and methods

130 Patients enrolled in our study were divided into LPR group and non-LPR group according to the scores of RSI and RFS. All individuals received endoscopic NBI tests and salivary pepsin measurements. NBI views of the larynx were divided into four grades based on the existing descriptive guidelines and our clinical observations, and the correlation between NBI grading and salivary pepsin levels was calculated.

Results

NBI grading and pepsin levels are significantly correlated with RFS/RSI scores. The diagnostic concentration of salivary pepsin was 33 ng/ml. There was a significant correlation between NBI grading and salivary levels.

Conclusions and significance

NBI grading system was proved to provide a better diagnostic value in the diagnosis of LPR. There was a possibility that a combination of these two methods might increase the diagnostic accuracy of this disease.

Chinese abstract

背景：声带白斑的诊断主要依靠喉镜检查。喉镜下声带白斑的形态特征与白斑的病理性质密切相关。与高危声带白斑相关的具体表现仍有待探索。

目的：通过传统白光成像 (WLI) 喉镜检查, 探讨低危和高危声带白斑的特点以及与窄带成像(NBI) 喉镜检查的相关性。

方法：将175例声带白斑患者分为低危和高危人群。 分析了WLI喉镜下低危和高危声带白斑的特点及其与 NBI 喉镜检查的相关性。

结果：逻辑回归分析显示厚度和充血是独立因素(p < .05)。NBI喉镜下, 充血与斑点可视化有很强的一致性（卡伯 ¼ 0.758）。充血征象和 NBI 分类, 对于预测声带白斑癌变的风险, 具有相等的诊断有效性。

结论：WLI喉镜下充血征象与NBI喉镜下可见的斑点具有显著相关性。充血是预测声带白斑可能恶变的重要特征。

Keywords:

• Laryngopharyngeal reflux
• narrow-band imaging
• salivary pepsin
• diagnosis

Acknowledgements

First, I am grateful to my colleagues for their invaluable assistance during the RFS/RSI score evaluation and NBI examination. I also would like to express my gratitude to the clinical laboratory department for their support in the pepsin testing.

Disclosure statement

The authors have no conflicts of interest to declare.