Helicobacter pylori is associated with poor prognosis of laryngeal precancerous lesion.
OBJECTIVES
Previous evidence suggested Helicobacter pylori (H. pylori) promoted tumorigenesis by inducing inflammation in gastric premalignant disease. Whether this organism affected the development of head and neck precancerous lesion remains unknown. We performed this study to assess the prognostic impact of H. pylori infection on patients with laryngeal precancerous lesion.


METHODS
In this prospective study, 41 enrolled patients with laryngeal precancerous lesion were arranged into H. pylori-positive group (n=16) and H. pylori-negative group (n=25). Two poor outcomes were recurrence and malignant transformation. Prognostic impact of H. pylori infection was analyzed using the Univariate Cox proportional hazard model and Cochran-Mantel-Haenszel test. We also analyzed the prognostic value of systemic inflammation-based markers.


RESULTS
During a median follow-up of 32.9 months, recurrence developed in 8 patients in the H. pylori positive group and 5 patients in the H. pylori negative group (50.0% vs. 20.0%, P=0.026, Log-rank test). Malignant transformation developed in 4 patients in the H. pylori positive group and no patients in the H. pylori negative group (25.0% vs. 0.0%, P=0.005, Log-rank test). H. pylori positive group had a significant higher malignant transformation rate after stratifying on the observed covariates. There was no significant difference of recurrence rate in two groups stratified with laryngopharyngeal reflux, size of lesion, and pathological type (Cochran-Mantel-Haenszel test). The basal levels of lymphocyte counts and neutrophils to lymphocytes ratio were significantly different in patients with H. pylori infection. Moreover, the receiver operating characteristic curve analysis revealed a predictive value of lymphocyte counts and neutrophils to lymphocytes ratio for poor outcomes (areas under the curve, 0.658 and 0.651, respectively).


CONCLUSION
The data demonstrate a malignant transformation-relevant role of H. pylori in laryngeal precancerous lesion. H. pylori infection combined with laryngopharyngeal reflux, size of lesion, and pathological type might relate to recurrence of laryngeal precancerous lesion. And changes of lymphocyte counts and neutrophils to lymphocytes ratio associated with H. pylori infection might deserve as predictive indicators for poor prognosis of laryngeal precancerous lesion.
['Chen|Min|M|', 'Fang|Yi|Y|', 'Cheng|Lei|L|', 'Wu|Haitao|H|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D015897:Comorbidity D005260:Female D016481:Helicobacter Infections D016480:Helicobacter pylori D006801:Humans D007822:Laryngeal Neoplasms D007958:Leukocyte Count D007971:Leukoplakia D018655:Lymphocyte Count D008297:Male D008875:Middle Aged D009504:Neutrophils D011230:Precancerous Conditions D011379:Prognosis D016016:Proportional Hazards Models D012008:Recurrence D000077195:Squamous Cell Carcinoma of Head and Neck D014827:Vocal Cords
Helicobacter pylori Laryngeal precancerous lesion Recurrence Malignant transformation Neutrophils to lymphocytes ratio