상부기관식도점막 질환에서 요소호기검사를 이용한 헬리코박터 파이로리 감염 연구

Introduction and Objectives:Helicobacter pylori is a slow-growing, microaerophilic, high motile, gram-negative spiral or helical organism. The most striking biochemical characteristic is the abundant production of urease. This enzyme is an important colonization factor and an indirect marker of the organism. H. pylori infection is related with gastritis, peptic ulcer disease, gastric adenocarcinoma, and mucosa associated lymphoid tissue (MALT) lymphoma in stomach. This study investigated that the positive rate of H. pylori infection and the degree of infection can reflect the severity of disease by use of 14C-Urea breath test (UBT) in the upper aerodigestive tract mucosal disease and focused only in the laryngeal disease. Materials and Methods: From August 2003 to December 2005, 237 patients with upper aerodigestive tract mucosal disease were included in this study. These cases were as follows, 165 cases of benign mucosal disease, 12 cases of premalignant disease and 60 cases of malignant disease. We performed two protocols ? Protocol 1 is on the whole upper aerodigestive tract mucosal disease and Protocol 2 is on the laryngeal disease only. Characteristics of the bacteria expression in patients were checked up by 14C-Urea breath test. The risk estimate analysis was done in sex, age, smoking use, and alcohol consumption by H. pylori infection positivity. Subgroup analyses were done among the cases by tumor site, stage, or differentiation in the incidence of H. pylori infection positivity. Results: The UBT positivity was similar between benign, premalignant and malignant disease in upper aerodigestive mucosal disease group and laryngeal mucosal disease group (Chi-square test, Protocol 1 p=0.7188, Protocol 2 p=0.6845). The infection severity in three types of diseases was not shown significant differences in both protocols either (ANOVA test, Protocol 1 p=0.3121, Protocol 2 p=0.4975). As far as concerned in malignant disease, only the nodal metastasis showed correlation with the in- fectivity other than the tumor site, differentiation in tumor factors of 59 malignant cases. We could notice also that there is an increased tendency of infection in the higher stage (p=0.06). Conclusions: We conclude that H. pylori infection doesn’t play a role in the pathogenesis of upper aerodigestive tract mucosal diseases nor impact on the laryngeal carcinogenesis. However, repetitive work on the nodal status or stage of head and neck cancers may be informative. (J Clinical Otolaryngol 2008;19:72–78)