{"title":"质子泵抑制剂治疗减少喉癌手术后肉芽组织持续时间：一项回顾性队列研究。","authors":"Jingjing Wang, Chunhe Zhang, Yanan Liu","doi":"10.2147/CMAR.S544365","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Granulation tissue formation complicates laryngeal cancer surgery recovery and may be exacerbated by laryngopharyngeal reflux. We investigated whether postoperative proton pump inhibitor (PPI) therapy reduces granulation tissue duration through reflux-mediated mechanisms.</p><p><strong>Methods: </strong>This retrospective cohort study included 89 laryngeal cancer patients undergoing function-preserving surgery (May 2020-December 2024). Patients received either postoperative PPI therapy (n=32) or standard care (n=57). Primary endpoint was granulation tissue duration. Secondary endpoints included Reflux Symptom Index (RSI) and Reflux Finding Score (RFS) changes. Mediation analysis explored whether PPI effects operated through reflux improvement.</p><p><strong>Results: </strong>Granulation formation rates were comparable between groups (65.6% vs 57.9%, P=0.188). Among patients developing granulation tissue (n=54), the PPI group demonstrated significantly shorter duration (4.0 [4.0, 5.0] vs 8.0 [6.0, 9.0] weeks, P<0.001). PPI therapy produced superior improvements in RSI (14.0 [13.0, 16.0] vs 4.0 [3.0, 4.0], P<0.001) and RFS scores (8.0 [6.8, 9.0] vs 2.0 [1.0, 3.0], P<0.001). Strong negative correlations existed between reflux improvement and granulation duration (RSI: r=-0.76; RFS: r=-0.74, both P<0.001). Mediation analysis revealed RSI improvement accounted for 16.18% of PPI's therapeutic effect. Benefits were most pronounced in females, early-stage tumors, and patients with lower baseline RSI scores.</p><p><strong>Conclusion: </strong>Postoperative PPI therapy significantly reduces granulation tissue duration following laryngeal cancer surgery through both reflux-dependent and independent mechanisms, supporting routine perioperative acid suppression in this population.</p>","PeriodicalId":9479,"journal":{"name":"Cancer Management and Research","volume":"17 ","pages":"2169-2181"},"PeriodicalIF":2.6000,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479377/pdf/","citationCount":"0","resultStr":"{\"title\":\"Proton Pump Inhibitor Therapy Reduces Granulation Tissue Duration Following Laryngeal Cancer Surgery: A Retrospective Cohort Study.\",\"authors\":\"Jingjing Wang, Chunhe Zhang, Yanan Liu\",\"doi\":\"10.2147/CMAR.S544365\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Granulation tissue formation complicates laryngeal cancer surgery recovery and may be exacerbated by laryngopharyngeal reflux. We investigated whether postoperative proton pump inhibitor (PPI) therapy reduces granulation tissue duration through reflux-mediated mechanisms.</p><p><strong>Methods: </strong>This retrospective cohort study included 89 laryngeal cancer patients undergoing function-preserving surgery (May 2020-December 2024). Patients received either postoperative PPI therapy (n=32) or standard care (n=57). Primary endpoint was granulation tissue duration. Secondary endpoints included Reflux Symptom Index (RSI) and Reflux Finding Score (RFS) changes. Mediation analysis explored whether PPI effects operated through reflux improvement.</p><p><strong>Results: </strong>Granulation formation rates were comparable between groups (65.6% vs 57.9%, P=0.188). Among patients developing granulation tissue (n=54), the PPI group demonstrated significantly shorter duration (4.0 [4.0, 5.0] vs 8.0 [6.0, 9.0] weeks, P<0.001). PPI therapy produced superior improvements in RSI (14.0 [13.0, 16.0] vs 4.0 [3.0, 4.0], P<0.001) and RFS scores (8.0 [6.8, 9.0] vs 2.0 [1.0, 3.0], P<0.001). Strong negative correlations existed between reflux improvement and granulation duration (RSI: r=-0.76; RFS: r=-0.74, both P<0.001). Mediation analysis revealed RSI improvement accounted for 16.18% of PPI's therapeutic effect. Benefits were most pronounced in females, early-stage tumors, and patients with lower baseline RSI scores.</p><p><strong>Conclusion: </strong>Postoperative PPI therapy significantly reduces granulation tissue duration following laryngeal cancer surgery through both reflux-dependent and independent mechanisms, supporting routine perioperative acid suppression in this population.</p>\",\"PeriodicalId\":9479,\"journal\":{\"name\":\"Cancer Management and Research\",\"volume\":\"17 \",\"pages\":\"2169-2181\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-09-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479377/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cancer Management and Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/CMAR.S544365\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancer Management and Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/CMAR.S544365","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：肉芽组织形成使喉癌手术恢复复杂化，并可能因喉部反流而加重。我们研究了术后质子泵抑制剂（PPI）治疗是否通过反流介导的机制缩短肉芽组织持续时间。方法：本回顾性队列研究包括89例接受功能保留手术的喉癌患者（2020年5月- 2024年12月）。患者接受术后PPI治疗（n=32）或标准治疗（n=57）。主要终点为肉芽组织持续时间。次要终点包括反流症状指数（RSI）和反流发现评分（RFS）变化。中介分析探讨了PPI是否通过改善反流而起作用。结果：两组间肉芽形成率具有可比性（65.6% vs 57.9%， P=0.188）。在出现肉芽组织的患者（n=54）中，PPI组的持续时间明显缩短（4.0 [4.0,5.0]vs 8.0[6.0, 9.0]周）。结论：术后PPI治疗通过反流依赖性和独立机制显著减少喉癌手术后肉芽组织持续时间，支持该人群围手术期常规抑酸。
Proton Pump Inhibitor Therapy Reduces Granulation Tissue Duration Following Laryngeal Cancer Surgery: A Retrospective Cohort Study.
Background: Granulation tissue formation complicates laryngeal cancer surgery recovery and may be exacerbated by laryngopharyngeal reflux. We investigated whether postoperative proton pump inhibitor (PPI) therapy reduces granulation tissue duration through reflux-mediated mechanisms.
Methods: This retrospective cohort study included 89 laryngeal cancer patients undergoing function-preserving surgery (May 2020-December 2024). Patients received either postoperative PPI therapy (n=32) or standard care (n=57). Primary endpoint was granulation tissue duration. Secondary endpoints included Reflux Symptom Index (RSI) and Reflux Finding Score (RFS) changes. Mediation analysis explored whether PPI effects operated through reflux improvement.
Results: Granulation formation rates were comparable between groups (65.6% vs 57.9%, P=0.188). Among patients developing granulation tissue (n=54), the PPI group demonstrated significantly shorter duration (4.0 [4.0, 5.0] vs 8.0 [6.0, 9.0] weeks, P<0.001). PPI therapy produced superior improvements in RSI (14.0 [13.0, 16.0] vs 4.0 [3.0, 4.0], P<0.001) and RFS scores (8.0 [6.8, 9.0] vs 2.0 [1.0, 3.0], P<0.001). Strong negative correlations existed between reflux improvement and granulation duration (RSI: r=-0.76; RFS: r=-0.74, both P<0.001). Mediation analysis revealed RSI improvement accounted for 16.18% of PPI's therapeutic effect. Benefits were most pronounced in females, early-stage tumors, and patients with lower baseline RSI scores.
Conclusion: Postoperative PPI therapy significantly reduces granulation tissue duration following laryngeal cancer surgery through both reflux-dependent and independent mechanisms, supporting routine perioperative acid suppression in this population.
期刊介绍：
Cancer Management and Research is an international, peer reviewed, open access journal focusing on cancer research and the optimal use of preventative and integrated treatment interventions to achieve improved outcomes, enhanced survival, and quality of life for cancer patients. Specific topics covered in the journal include:
◦Epidemiology, detection and screening
◦Cellular research and biomarkers
◦Identification of biotargets and agents with novel mechanisms of action
◦Optimal clinical use of existing anticancer agents, including combination therapies
◦Radiation and surgery
◦Palliative care
◦Patient adherence, quality of life, satisfaction
The journal welcomes submitted papers covering original research, basic science, clinical & epidemiological studies, reviews & evaluations, guidelines, expert opinion and commentary, and case series that shed novel insights on a disease or disease subtype.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
