Detection of a Common Gastric Microorganism in Upper Airway Tissues Among Individuals with Malignancy of the Voice Box

Abstract

Helicobacter pylori is known to be a leading cause of persistent bacterial infections in humans. While primary risk contributors to malignancy in the voice box region include tobacco use, alcohol consumption, and certain viral agents, emerging evidence has noted the bacterium’s presence beyond the gastrointestinal tract—specifically in oral biofilms, saliva, the middle ear, and paranasal sinuses. Prior reports have detected this microorganism in association with laryngeal malignancies but often fail to identify the origin of colonization, whether gastric or oral. This study aimed to investigate the prevalence and co-occurrence of this bacterial agent in both the stomach and upper airway structures of individuals diagnosed with laryngeal squamous cell carcinoma.

A prospective analysis was conducted on 51 patients with histologically confirmed laryngeal squamous cell carcinoma, as diagnosed independently by two pathologists. All participants underwent upper gastrointestinal endoscopy, during which biopsy specimens were collected from both gastric and laryngeal regions. The presence of the organism was evaluated using histological staining as well as DNA amplification via a standardized fluorescent PCR-based detection method.

Findings revealed concurrent bacterial colonization in both gastric and laryngeal tissues in several cases, supporting the theory of upward transmission from the digestive tract to the airway. Interestingly, there were also instances where the bacterium was detected only in laryngeal tissue but not in the stomach, pointing to a potential alternative pathway of transmission, possibly originating from the oral environment. These results indicate that colonization of laryngeal carcinoma tissue by this pathogen may occur via multiple routes, suggesting both ascending and descending migration within the aerodigestive tract.