胃蛋白酶与咽喉反流性疾病:从致病机制到咽喉鳞状细胞癌的潜在风险因素  

Pepsin and laryngopharyngeal reflux disease:from pathogenic mechanisms to potential risk factors for pha-ryngeal and laryngeal squamous cell carcinoma

作　　者：周诗侗 杨艳艳 杨玉成[2] 方红雁 ZHOU Shitong;YANG Yanyan;YANG Yucheng;FANG Hongyan(Department of Otorhinolaryngology&Head and Neck Surgery,Chongqing General Hospital,Chongqing 401147,China;Department of Otorhinolaryngology&Head and Neck Surgery,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆市人民医院耳鼻咽喉头颈外科,重庆401147 [2]重庆医科大学附属第一医院耳鼻咽喉头颈外科,重庆400016

出　　处：《山东大学耳鼻喉眼学报》2024年第6期55-60,共6页Journal of Otolaryngology and Ophthalmology of Shandong University

基　　金：重庆市科卫联合面上项目(2023MSXM120);重庆市技术创新与应用发展专项面上项目(CSTB2022TIAD-GPX0065);重庆市人民医院医学科技创新基金面上项目(Y2020MSXM16)

摘　　要：咽喉反流性疾病(laryngopharyngeal reflux disease, LPRD)是由胃十二指肠内容物反流的直接或间接作用引起的上呼吸消化道组织的一种炎症疾病,胃蛋白酶是其主要致病因子。近年来,越来越多研究发现咽喉反流与咽喉鳞状细胞癌关系密切,但咽喉反流是否咽喉鳞状细胞癌的危险因素尚存争议。胃蛋白酶作为LPRD的主要致病因子,可能在咽喉鳞状细胞癌的发生发展中有重要作用,其机制包含咽喉黏膜上皮损伤、上皮防御屏障的破坏、诱导炎症、诱导基因及miRNA改变等。论文针对胃蛋白酶与LPRD,从致病机制及咽喉鳞状细胞癌的潜在风险因素方面进行综述,旨在为探寻咽喉鳞状细胞癌新的致病机制和治疗手段提供新的研究思路。Laryngopharyngeal reflux disease(LPRD)is an inflammatory disease of the tissues of the upper aerodigestive tract caused by the direct or indirect action of reflux of gastroduodenal contents,with pepsin as the main causative agent.Numerous stud-ies have shown a strong association between laryngeal reflux and squamous cell carcinoma of the pharynx and larynx.Nonetheless,the ongoing debate as to whether laryngeal reflux is a risk factor for laryngeal squamous cell carcinoma remains inconclusive.Pepsin,the main pathogenic factor of LPRD,has been shown to play a crucial role in the oncogenesis of squamous cell carcinoma of the pharynx and larynx.Possible mechanisms include damage to the epithelium of the pharyngeal and laryngeal mucosa,disruption of the epithelial defense barrier,induction of inflammation,and alterations in genes and miRNA.This article provides a comprehensive review of the role and mechanism of LPRD,with a special focus on pepsin,in terms of pathogenic mechanisms and potential risk factors for pharyngeal and laryngeal squamous cell carcinoma,with the aim of facilitating the explanation of oncogenesis and inspir-ing innovative therapeutic approaches in this disease.

关 键 词：咽喉反流 胃蛋白酶 鳞状细胞癌 黏膜损伤 致病机制 

分 类 号：R767.6[医药卫生—耳鼻咽喉科]