[en] [en] OBJECTIVE: To study the diagnostic value of salivary pepsin measurement (Peptest) for detecting gastroesophageal reflux disease (GERD) in laryngopharyngeal reflux (LPR) patients.
METHODS: Patients with reflux symptoms were consecutively recruited from January 2020 to November 2022. Patients benefited from hypopharyngeal-esophageal impedance-pH monitoring (HEMII-pH), fasting and bedtime saliva collections to measure pepsin. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values were evaluated for GERD and LPR patients considering the highest values of pepsin tests at ≥ 16, ≥ 75, and ≥ 216 ng/mL cutoffs. The relationship between HEMII-pH, endoscopic and clinical findings, and pepsin measurements was studied.
RESULTS: Saliva was collected in 109 LPR patients and 30 individuals with both LPR and GERD. The total number of pharyngeal reflux events was significantly higher in GERD-LPR patients compared with LPR patients (p = 0.008). The mean fasting and bedtime pepsin saliva concentrations were similar between groups. The sensitivity of Peptest in LPR patients was 30.5%, 70.2%, and 84.0% at cutoffs ≥ 16, ≥ 75 and ≥ 216 ng/mL. In GERD-LPR group, Peptest was 80.0%, 70.0%, and 30.0% sensitive. At cutoff 16 ng/mL, Peptest reported PPV of 20.7% and 94.8% in LPR-GERD and LPR groups, respectively. NPV were 73.9% and 8.7% in GERD-LPR and LPR groups, respectively. The consistency analysis between Peptest and HEMII-pH was not significant. Peptest was significantly associated with the number of acid pharyngeal reflux events (rs = 0.182; p = 0.032).
CONCLUSION: Pepsin saliva measurements appear to be not a reliable diagnostic tool for the detection of GERD in LPR patients. Future studies are needed to determine the place of Peptest in laryngopharyngeal reflux and gastroesophageal reflux diseases.
Disciplines :
Otolaryngology
Author, co-author :
Lechien, Jérome ; Université de Mons - UMONS > Faculté de Psychologie et des Sciences de l'Educatio > Service de Métrologie et Sciences du langage
Bobin, Francois; Polyclinique Elsan de Poitiers, Poitiers, France
Language :
English
Title :
Saliva pepsin measurements in the detection of gastroesophageal reflux disease in laryngopharyngeal reflux patients: a cohort study.
Publication date :
August 2023
Journal title :
European Archives of Oto-Rhino-Laryngology
ISSN :
0937-4477
eISSN :
1434-4726
Publisher :
Springer Science and Business Media Deutschland GmbH, Germany
M112 - Anatomie humaine et Oncologie expérimentale
Research institute :
R550 - Institut des Sciences et Technologies de la Santé R350 - Institut de recherche en sciences et technologies du langage
Funders :
Iris grant brussels
Funding text :
Vesale Grant & IRIS-Recherche Grant (Foundation Roi Baudouin). The study is funded by the Groupement de Coopération Sanitaire ELSAN, 58 bis rue de la Boétie, 75008 Paris, France.
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