Pepsin in saliva as a diagnostic biomarker in laryngopharyngeal reflux: a meta-analysis

Abstract

Objective

Pepsin in saliva has been proposed as a biomarker for the diagnosis of laryngopharyngeal reflux (LPR), but the results remain controversial. We assessed the diagnostic value of pepsin in saliva for LPR.

Methods

PubMed, Embase, and Web of Science were searched for studies in English that evaluated the utility of pepsin in saliva in the diagnosis of LPR, published up to 15 March 2017. We used Stata 12.0 to summarize the diagnostic indexes for the meta-analysis.

Results

Eleven eligible studies met the inclusion criteria. After the meta-analysis of included studies, the pooled sensitivity and specificity were 64% [95% confidence interval (CI) 43–80%] and 68% (95% CI 55–78%), respectively; the positive (PLR) and negative (NLR) likelihood ratios were 2.0 (95% CI 1.4–2.9) and 0.54 (95% CI 0.33–0.87), respectively; the diagnostic odds ratio (DOR) was 4 (95% CI 2–8); and the area under the curve (AUC) was 0.71 (95% CI 0.67–0.75).

Conclusion

Pepsin in saliva has moderate value in the diagnosis of LPR. The cutoff value used could affect the diagnostic value. Therefore, further investigations are required to find the optimal method to detect salivary pepsin in diagnosing LPR.

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