Open Access

Bile reflux and hypopharyngeal cancer (Review)

  • Authors:
    • Dimitra P. Vageli
    • Sotirios G. Doukas
    • Panagiotis G. Doukas
    • Benjamin L. Judson
  • View Affiliations

  • Published online on: September 23, 2021
  • Article Number: 244
  • Copyright: © Vageli et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Laryngopharyngeal reflux, a variant of gastroesophageal reflux disease, has been considered a risk factor in the development of hypopharyngeal cancer. Bile acids are frequently present in the gastroesophageal refluxate and their effect has been associated with inflammatory and neoplastic changes in the upper aerodigestive tract. Recent in vitro and in vivo studies have provided direct evidence of the role of acidic bile refluxate in hypopharyngeal carcinogenesis and documented the crucial role of NF‑κB as a key mediator of early oncogenic molecular events in this process and also suggested a contribution of STAT3. Acidic bile can cause premalignant changes and invasive squamous cell cancer in the affected hypopharynx accompanied by DNA damage, elevated p53 expression and oncogenic mRNA and microRNA alterations, previously linked to head and neck cancer. Weakly acidic bile can also increase the risk for hypopharyngeal carcinogenesis by inducing DNA damage, exerting anti‑apoptotic effects and causing precancerous lesions. The most important findings that strongly support bile reflux as an independent risk factor for hypopharyngeal cancer are presented in the current review and the underlying mechanisms are provided.
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Vageli DP, Doukas SG, Doukas PG and Judson BL: Bile reflux and hypopharyngeal cancer (Review). Oncol Rep 46: 244, 2021
Vageli, D.P., Doukas, S.G., Doukas, P.G., & Judson, B.L. (2021). Bile reflux and hypopharyngeal cancer (Review). Oncology Reports, 46, 244.
Vageli, D. P., Doukas, S. G., Doukas, P. G., Judson, B. L."Bile reflux and hypopharyngeal cancer (Review)". Oncology Reports 46.5 (2021): 244.
Vageli, D. P., Doukas, S. G., Doukas, P. G., Judson, B. L."Bile reflux and hypopharyngeal cancer (Review)". Oncology Reports 46, no. 5 (2021): 244.