Correlation Analysis Of Laryngopharyngeal Reflux And HPV Infection In The Oropharynx

Objective:The incidence of oropharyngeal papilloma in laryngopharyngeal reflux(LPR)has been confirmed by clinical observation.In this study,the positive immunohistochemical results of pepsin were used as the gold standard for the diagnosis of pharyngeal reflux,and the relationship and correlation between pharyngeal reflux and oropharyngeal HPV infection were preliminarily explored,providing new ideas for the future clinical prevention,diagnosis and treatment of pharyngeal papilloma virus infection.Methods:Patients with obstructive sleep apnea hypopnea syndrome(OSAHS)with oropharyngeal papilloma who were admitted to our hospital between December 2021 and December 2022 for surgical treatment were selected.The characteristics of reflux symptom index(RSI)and reflux finding score(RFS)were investigated.RSI scores >13 and RFS>7 were classified as suspected laryngeal reflux group,and a total of 24 cases were included.At the same time,patients diagnosed with chronic tonsillitis and requiring surgical treatment were selected and scored on the scale.Patients with RSI≤13 and RFS≤7 were classified as non-pharyngeal reflux group,and a total of 20 cases were included.Tissue samples were collected from postoperative oropharyngeal mucosa of the two groups.First,the expression results of pepsin were detected by immunohistochemistry.20 patients in the suspected pharyngeal reflux group were screened out as pepsin positive group according to Formwitz score.18 patients in non-pharyngeal reflux group were classified as negative pepsin group.The relative quantification of HPV DNA in the oral and pharyngeal mucosa tissues of the two groups was detected by real-time fluorescence quantitative PCR.The obtained data and clinical data were analyzed by statistical software,and P < 0.05 was considered statistically significant.Results:Among the 24 suspected laryngopharyngeal reflux group,20 patients were pepsin positive,with a positive rate of 83.3%.Among the 20 patients in the non-pharyngeal reflux group,2 were pepsin positive,with a positive rate of 10%.The positive rate of pepsin was significantly different between suspected laryngeal reflux group and non-laryngeal reflux group(P<0.01).There was no significant difference in the general clinical data between the two groups(P>0.05).The consistency rate of RSI and RFS scales was 86.36% with that of pepsin immunohistochemistry(k=0.727,P<0.001).The sensitivity and specificity of RSI and RFS scales were 90.9%(20/22)and 81.8%(18/22)respectively,using pepsin immunohistochemistry as the standard for the diagnosis of pharyngeal reflux.There was no significant difference in general information between pepsin positive group and pepsin negative group(P>0.05).Among the 20 patients in the pepsin positive group,3 patients(15%)were HPV-positive,all of which were HPV11 type,while 18 patients in the pepsin negative group were HPV negative.Conclusions:1.There was moderate consistency between the immunohistochemical results of pepsin and the scores of RSI and RFS.2.RSI and RFS scales are sensitive methods for the diagnosis of pharyngeal reflux and can be used as clinical screening;3.The detection rate of HPV DNA in the oral and pharyngeal mucosal tissues of patients in the pepsin positive group was higher than that in the pepsin negative group,but there was no statistical difference in the expression of HPV DNA between the two groups.4.Oral and pharyngeal mucosal HPV infection was not correlated with gender,age,BMI,tobacco and alcohol history in the pepsin positive group.5.Laryngopharyngeal reflux can lead to the development of HPV-associated tumors.