Investigation of Helicobacter pylori colonization in laryngeal neoplasia.

Helicobacter pylori has been investigated in several other organ systems and localizations such as the oral cavity, but has not been investigated extensively in squamous cell carcinoma of the larynx, a region that could be directly exposed to the bacterium by the oral route or gastro-esophageal reflux. Only serological studies are available regarding the relation between H. pylori and laryngeal cancer, yielding conflicting results. To our knowledge, there is no study investigating the presence of H. pylori in laryngeal squamous cell carcinoma tissue. The purpose of this study was to investigate the presence of H. pylori in laryngeal squamous cell carcinoma tissue and to investigate the possible role of this organism in the etiopathogenesis of laryngeal cancer. Specimens from 50 patients with laryngeal cancer who underwent total or partial laryngectomy between March 1999 and December 2002 were examined by histopathological and immunohistochemical methods to detect H. pylori. The presence of H. pylori was also investigated histopathologically in 50 benign laryngeal biopsy specimens. In our study, we demonstrated that H. pylori was not present in laryngeal squamous cell carcinoma tissue or in the benign lesions. We could not find any evidence indicating that H. pylori played a role at the tissue level in the pathogenesis of laryngeal carcinoma.

Heterotopic gastric mucosa in the cervical esophagus (inlet patch): endoscopic prevalence, histological and clinical characteristics.

BACKGROUND AND AIM: Heterotopic gastric mucosal patch, which has a 0.1-10% frequency, is encountered when the cervical esophagus is examined carefully during endoscopy. In this study, we aimed to determine the prevalence of the patch in the cervical esophagus, to identify its macroscopic and histological characteristics and to evaluate demographic and clinical features. METHODS: Six hundred and sixty patients (317 male, 343 female; mean age 50.28 years, range 14-90) with upper gastrointestinal symptoms had elective esophagogastroduodenoscopy and the cervical esophagus was examined for the patch during withdrawal of the endoscope. Biopsies were obtained from the antrum and the patch. Helicobacter pylori was assessed using an immunohistochemical method. RESULTS: The patch was found in 11 patients of 660, with a prevalence of 1.67%. Patch size ranged between 5 and 30 mm, appeared as a single patch in nine patients and as twin patches in two patients. Mean age and male : female ratio were not significantly different from the patient population without patches, but the female sex was predominant (three men, eight women; mean age 43.6 years, range 32-64). In five of 11 patients, the upper esophageal and laryngopharyngeal symptoms were remarkable. Eight patients in whom histological confirmation was carried out showed three fundic and five antral-type mucosa. Two of five patients with antral H. pylori also had the bacteria in the patch. H. pylori prevalence in the patch was 25%. CONCLUSION: Heterotopic gastric mucosal patches in the proximal esophagus should not be overlooked during endoscopy because they may lead to important complications in relation to their acid secretion, which may vary according to their parietal cell mass.