UreA and cagA genes of Helicobacter pylori in Egyptian patients with laryngeal squamous cell carcinoma and benign laryngeal polyps: a cohort study

Is Laryngeal Squamous Cell Carcinoma Related to Helicobacter pylori?

Background

Laryngeal carcinoma is a primary malignant tumor originating from the laryngeal mucosa. In recent years, an increasing number of studies have confirmed that Helicobacter pylori may play a role in the occurrence and development of laryngeal cancer. We conducted a systematic review and meta-analysis to identify and emphasize the relationship between laryngeal cancer and Helicobacter pylori infection.

Methods

We actively searched for systematic reviews of PubMed, Embase, Web of Science, and Cochrane libraries to select studies that met the recommended guidelines. A total of 1756 patients with laryngeal cancer were included in this study to assess the association of Helicobacter pylori in the larynx with laryngeal cancer. A subassessment of the risk of bias for each study that met the inclusion criteria was carried out. To illustrate the reasons for heterogeneity, we performed a subgroup analysis to determine the type of study, the quality of the article, the diagnostic method, and the impact of exposure factors.

Results

The meta-analysis included a total of 17 case-control studies on the association between Helicobacter pylori in the larynx and laryngeal cancer. Our meta-analysis showed that Helicobacter pylori infection in the larynx significantly increased the risk of malignant tumors in the larynx (odds ratio, 2.96; 95% CI, 1.83-4.78; P<0.00001; I^{2 =} 86%). They still existed when we controlled for patients’ exposure to smoking factors (odds ratio, 3.86; 95% CI, 1.89–7.88).

Conclusion

This systematic review and meta-analysis showed an association between Helicobacter pylori and laryngeal cancer. These findings are consistent with the understanding that chronic inflammatory tissue insult may lead to the development of malignancy. Controlling risk factors will help us identify patients with an increased risk of laryngeal cancer.

Laryngeal Helicobacter pylori Infection and Laryngeal Cancer-Case Series and a Systematic Review

Helicobacter pylori (H. pylori) infection involves the development of gastric cancer and may be associated with laryngeal cancer. However, laryngeal H. pylori infection in Taiwanese patients with newly diagnosed laryngeal cancer has not been reported. This study was aimed to investigate the possible association between laryngeal H. pylori infection and laryngeal cancer in Taiwan and perform a systematic review of previous reports in other countries. An analysis of 105 patients with laryngeal lesions found the positive rates of H. pylori DNA (determined by polymerase chain reaction) and antigen (determined by immunohistochemistry) of the laryngeal lesions were relatively low (vocal polyps: 3% and 3%; vocal fold leukoplakia: 0% and 0%; laryngeal cancers: 0% and 2%). Furthermore, H. pylori-associated laryngopharyngeal reflux and the expression of E-cadherin and CD1d (determined by immunohistochemistry) were comparable among the three subgroups. Fifteen studies were involved in the systematic review of the digital literature database, distributed to February 2021. The data of patients with laryngeal cancer and controls showed that the laryngeal H. pylori infection rates were 29.4% and 16.7%, respectively. Although current evidence supported that laryngeal H. pylori infection was associated with laryngeal cancer globally, it might not play a role in the development of laryngeal cancer in Taiwan.

Helicobacter pylori in Otorhinolaryngology: Cause or Bystander

The bacteria Helicobacter pylori (H. pylori) have been identified in the extragastric tissues in the head and neck. The origin and pathogenicity of these bacteria in the head and neck are not known. Gastric reflux and nasal or oral routes are the possible modes of spread. In many sinonasal, pharyngeal, laryngeal, and middle ear disorders, laryngopharyngeal reflux has been identified as a contributing or causative factor. One possible mode by which laryngopharyngeal reflux may contribute is by seeding of the extragastric mucosa with H. pylori. The clinical significance of the discovery of H. pylori in extragastric tissues in the head and neck is unclear. There is no evidence of a pathologic or active role of H. pylori in otorhinolaryngological disorders. The suggestion that the sinonasal cavities and pharynx may serve as a reservoir for H. pylori and that reinfection of the stomach occurs after eradication therapy awaits further studies for confirmation. No connection was observed between H. pylori found in the stomach and H. pylori found in the head and neck. Also, these bacteria, found in the head and neck tissues, may be accidental or innocent bystanders that do not affect the pathways of otolaryngological and gastroduodenal diseases. This review examines the evidence for a possible relationship of H. pylori with otorhinolaryngological diseases.

Possible association between Helicobacter pylori infection and vocal fold leukoplakia

BACKGROUND

Several studies have indicated the larynx as possible Helicobacter pylori (H. pylori) reservoirs. This study explored the association between H. pylori and vocal fold leukoplakia.

METHODS

The case-control study involved 51 patients with vocal fold leukoplakia and 35 control patients with vocal polyps. Helicobacter pylori was detected in tissues by the rapid urease test, nested polymerase chain reaction (PCR), and single-step PCR. The H. pylori-specific immunoglobulin antibodies were detected in plasma by enzyme-linked immunosorbent assay (ELISA).

RESULTS

Helicobacter pylori-positive rate of vocal fold leukoplakia and vocal polyps was 23.5% versus 11.4% (P = .157), 37.2% versus 14.3% (P = .020), 27.5% versus 8.6% (P = .031), and 70.6% versus 68.6% (P = .841) detected by rapid urease test, nested PCR, single-step PCR, and ELISA, respectively. Regression analysis indicated that H. pylori infection (P = .044) was the independent risk factor for vocal fold leukoplakia.

CONCLUSION

Helicobacter pylori infection exists in the larynx and may be associated with vocal fold leukoplakia.