Immunohistochemical detection of pepsin in laryngeal mucosa for diagnosing laryngopharyngeal reflux.
Laryngoscope
; 121(7): 1426-30, 2011 Jul.
Article
in En
| MEDLINE
| ID: mdl-21647907
ABSTRACT
OBJECTIVES/HYPOTHESIS:
To investigate whether the pepsin immunohistochemical (IHC) staining of the laryngeal mucosa epithelia is an available test for diagnosing laryngopharyngeal reflux (LPR) in clinic. STUDYDESIGN:
Prospective case series.METHODS:
Biopsy specimens from interarytenoid mucosa of LPR patients (seven acid LPR and eight nonacid LPR) and 21 sex- and age-matched normal controls were obtained for pepsin IHC staining. The diagnosis of LPR was based on 24-hour combined multichannel intraluminal esophageal impedance pH monitoring. The results of IHC staining were semiquantitatively analyzed and scored as negative (-), weakly positive (+), moderately positive (++), and strongly positive (+++).RESULTS:
Six of seven acid LPR (85.7%) and six of eight nonacid LPR (75%) mucosa samples were moderate to strongly positive for intracellular pepsin. By contrast, only three of 21 normal controls (14.3%) were moderately positive. The difference in intracellular pepsin between LPR and the normal laryngeal mucosa was statistically significant (P < .01). No significant difference in intracellular pepsin was observed between the acid and nonacid LPR mucosal samples (P = .453). Using weak positivity (+) as a cutpoint, the presence of intracellular pepsin in the laryngeal mucosa had a sensitivity of 100% and a specificity of 47.6% in detecting LPR (P < .05). However, using the moderate positivity (++) as the cutpoint, the pepsin had a slightly decreased sensitivity of 80% but a sharply increased specificity of 85.7% (P < .05) in the detection of LPR.CONCLUSIONS:
Pepsin IHC staining of the laryngeal mucosa appears to be a sensitive and specific test for diagnosing LPR in a clinical application.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pepsin A
/
Laryngopharyngeal Reflux
/
Laryngeal Mucosa
Type of study:
Diagnostic_studies
/
Observational_studies
Limits:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Laryngoscope
Journal subject:
OTORRINOLARINGOLOGIA
Year:
2011
Document type:
Article
Affiliation country:
China