The significance of extraesophageal reflux as a risk factor in lung adenocarcinoma has been understudied. In this study, we investigated whether extraesophageal reflux leads to higher pepsin concentrations in bronchoalveolar lavage (BAL) in patients with lung adenocarcinoma compared to controls. Subjects were recruited from non-smoker patients (lifelong non-smokers and ex-smokers with more than 5 years of non-smoking history) who had undergone bronchoscopy due to pulmonary abnormalities on a CT scan and met the inclusion criteria. Based on histological verification of the lung process, the patients were divided into three groups: (1) lung adenocarcinoma, (2) pulmonary metastases, and (3) lung sarcoidosis. Lung adenocarcinoma cases were further categorized as central or peripheral. BAL samples collected during bronchoscopy were quantitatively analyzed by enzyme-linked immunosorbent assay (ELISA) to measure pepsin levels. No statistically significant difference in pepsin concentration was observed between the lung adenocarcinoma group and control groups (p= 0.135). After excluding hemorrhagic BAL samples, the pepsin concentration was significantly the lowest in patients with lung adenocarcinoma (p= 0.023) compared to the control groups. The results of the study do not support the hypothesis of a higher occurrence of extraesophageal reflux (evaluated as the amount of pepsin in BAL) in non-smoker patients with lung adenocarcinoma.
食管外反流作为肺腺癌风险因素的重要性尚未得到充分研究。本研究旨在探讨肺腺癌患者支气管肺泡灌洗液（BAL）中胃蛋白酶浓度是否高于对照组。研究对象为因CT扫描发现肺部异常且符合纳入标准的非吸烟患者（终身不吸烟者及戒烟超过5年者）。根据肺部病变的组织学验证结果，患者被分为三组：（1）肺腺癌组，（2）肺转移瘤组，（3）肺结节病组。肺腺癌病例进一步分为中央型与周围型。通过酶联免疫吸附试验（ELISA）对支气管镜检查期间采集的BAL样本进行胃蛋白酶水平的定量分析。肺腺癌组与对照组间的胃蛋白酶浓度未观察到统计学显著差异（p=0.135）。排除出血性BAL样本后，肺腺癌患者的胃蛋白酶浓度显著低于对照组（p=0.023）。本研究结果不支持非吸烟肺腺癌患者存在更高食管外反流发生率（以BAL中胃蛋白酶含量评估）的假说。
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