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The diagnostic value of pepsin concentration in saliva for laryngopharyngeal reflux disease

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Objective

To explore the diagnostic efficacy of pepsin concentration in saliva for laryngopharyngeal reflux (LPR) disease.

Methods

In this study, we recruited 40 participants with abnormal sensation of throat into the study who visited our hospital from March 2020 to December 2020. The 24 h multichannel intraluminal impedance and pH monitoring (24 h MII-pH), reflux symptom index (RSI) and reflux finding score (RFS), pepsin concentration in saliva were collected. The Cohen’s kappa test and receiver-operating characteristic (ROC) curves were performed to determine and compare the sensitivity and specificity of five diagnostic methods: RSI; RFS, pepsin concentration, RSI + RFS, RSI + RFS + pepsin concentration.

Results

The area under the curve (AUC) of RSI, RFS, pepsin concentration, RSI + RFS, RSI + RFS + pepsin concentration were 0.767, 0.733, 0.870, 0.750,0.867, respectively. That is, the pepsin concentration has maximum AUC (the cutoff point is 219.47 (ng/mL); the sensitivity and 1-specificity is 0.300, 0.933, respectively.). The positive predictive value was 90.3% (28/31), and the negative predictive value was 77.8% (7/9). The Cohen’s kappa coefficients of the five diagnostic subgroups were: RSI 0.486 (95% CI 0.207–0.764, P = 0.001); RFS 0.333 (95% CI 0.021–0.644, P = 0.032); RSI + RFS: 0.517 (95% CI 0.205–0.829, P = 0.001); pepsin concentration: 0.699 (95% CI 0.379–0.931, P = 0.001); RSI + RFS + pepsin concentration: 0.500 (95% CI 0.181–0.819, P < 0.001).

Conclusion

The pepsin concentration has the maximum AUC area and highest consistency with the 24 h MII-pH. Therefore, it has certain value in the screening and diagnosis of diseases related to LPR disease.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China

    Lei Yu, Rui Li & Yuliang Zhao

  2. Chemical Engineering Institute, Shijiazhuang University, Shijiazhuang, China

    Linnan Du

Authors
  1. Lei Yu
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  2. Rui Li
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  3. Linnan Du
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  4. Yuliang Zhao
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Correspondence to Yuliang Zhao.

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The author declares that they have no conflict of interest.

Ethical approval

Ethical approval for this study was granted by the research ethics committee of the Second Hospital of Hebei Medical University (approval number 2017R100). All methods were performed in accordance with the relevant guidelines and regulations. The health, rights and privacy of participants were fully protected. Potential risks to participants were minimal and controllable.

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Yu, L., Li, R., Du, L. et al. The diagnostic value of pepsin concentration in saliva for laryngopharyngeal reflux disease. Eur Arch Otorhinolaryngol 279, 5783–5789 (2022). https://doi.org/10.1007/s00405-022-07472-x

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  • DOI: https://doi.org/10.1007/s00405-022-07472-x

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