본문 바로가기
KERD
논문KCI 등재

Pepsin and Laryngeal and Hypopharyngeal Carcinomas

1

조회

0

다운로드

0

인용

0

참고문헌

키워드

초록

Laryngeal and hypopharyngeal carcinomas are common malignant tumors of the head and neck, and the incidence of both is increasing. Laryngopharyngeal reflux refers to the retrograde flow of gastric contents into the larynx, oropharynx, and/or nasopharynx. It remains controversial whether laryngopharyngeal reflux is a risk factor for laryngeal and hypopharyngeal cancers. The refluxing substances mainly include hydrochloric acid, pepsin, and occasionally bile acids and bile salts, as well as bacteria that colonize the gastrointestinal tract. Loss of epithelium in the mucous membrane of the larynx and hypopharynx is thought to be caused by pepsin. Here, we review the relationships between laryngopharyngeal reflux and both laryngeal and hypopharyngeal carcinomas, as well as the significance of pepsin, methods of clinical detection, and the mechanism of carcinogenesis.

Abstract

Laryngeal and hypopharyngeal carcinomas are common malignant tumors of the head and neck, and the incidence of both is increasing. Laryngopharyngeal reflux refers to the retrograde flow of gastric contents into the larynx, oropharynx, and/or nasopharynx. It remains controversial whether laryngopharyngeal reflux is a risk factor for laryngeal and hypopharyngeal cancers. The refluxing substances mainly include hydrochloric acid, pepsin, and occasionally bile acids and bile salts, as well as bacteria that colonize the gastrointestinal tract. Loss of epithelium in the mucous membrane of the larynx and hypopharynx is thought to be caused by pepsin. Here, we review the relationships between laryngopharyngeal reflux and both laryngeal and hypopharyngeal carcinomas, as well as the significance of pepsin, methods of clinical detection, and the mechanism of carcinogenesis.

참고문헌 (121)

  1. Bates JE, "Locally advanced hypopharyngeal and laryngeal cancer: influence of HPV status", Radiother Oncol, 140, pp.6~9 (2019)
  2. Acuna G, "Human papillomavirus in laryngeal and hypopharyngeal lymphoepithelial carcinoma", Mod Pathol, 32(5), pp.621~626 (2019)
  3. Du E, "Long-term survival in head and neck cancer: impact of site, stage, smoking, and human papillomavirus status", Laryngoscope, 129(11), pp.2506~2513 (2019)
  4. Marur S, "Head and neck squamous cell carcinoma: update on epidemiology, diagnosis, and treatment", Mayo Clin Proc, 91(3), pp.386~396 (2016)
  5. Alam MS, "Epidemiological profile of head and neck cancer patients in Western Uttar Pradesh and analysis of distributions of risk factors in relation to site of tumor", J Cancer Res Ther, 13(3), pp.430~435 (2017)
  6. Faggons CE, "Review: head and neck squamous cell carcinoma in sub-Saharan Africa", Malawi Med J, 27(3), pp.79~87 (2015)
  7. Rooper LM, "HPV-positive squamous cell carcinoma of the larynx, oral cavity, and hypopharynx: clinicopathologic characterization with recognition of a novel warty variant", Am J Surg Pathol, 44(5), pp.691~702 (2020)
  8. Nurgalieva ZZ, "A pilot study of Helicobacter pylori infection and risk of laryngopharyngeal cancer", Head Neck, 27(1), pp.22~27 (2005)
  9. Lechien JR, "Laryngopharyngeal reflux and voice disorders: a multifactorial model of etiology and pathophysiology", J Voice, 31(6), pp.733~752 (2017)
  10. Wilson JA, "What is the evidence that gastroesophageal reflux is involved in the etiology of laryngeal cancer?", Curr Opin Otolaryngol Head Neck Surg, 13(2), pp.97~100 (2005)
  11. Shimazu R, "Laryngeal granuloma in experimental rats with gastroesophageal reflux disease and mechanically injured vocal cord mucosa", Ann Otol Rhinol Laryngol, 123(4), pp.247~251 (2014)
  12. Sasaki CT, "In vitro model for gastroduodenal reflux-induced nuclear factor-kappaB activation and its role in hypopharyngeal carcinogenesis", Head Neck, 38(Suppl 1), pp.E1381~E1391 (2016)
  13. Gtari W, "Impact of macromolecular crowding on structure and properties of pepsin and trypsin", Mater Sci Eng C Mater Biol Appl, 72, pp.98~105 (2017)
  14. Wight R, "Current theories for the development of nonsmoking and nondrinking laryngeal carcinoma", Curr Opin Otolaryngol Head Neck Surg, 11(2), pp.73~77 (2003)
  15. Copper MP, "High incidence of laryngopharyngeal reflux in patients with head and neck cancer", Laryngoscope, 110(6), pp.1007~1011 (2000)
  16. Galli J, "The role of acid and alkaline reflux in laryngeal squamous cell carcinoma", Laryngoscope, 112(10), pp.1861~1865 (2002)
  17. Tan JJ, "Pepsin promotes IL-8 signaling-induced epithelial-mesenchymal transition in laryngeal carcinoma", Cancer Cell Int, 19, pp.64~ (2019)
  18. Anis MM, "Association of gastroesophageal reflux disease and laryngeal cancer", World J Otorhinolaryngol Head Neck Surg, 4(4), pp.278~281 (2018)
  19. Riley CA, "Detection of laryngeal carcinoma in the U.S. elderly population with gastroesophageal reflux disease", Head Neck, 41(5), pp.1434~1440 (2019)
  20. Parsel SM, "Gastroesophageal and laryngopharyngeal reflux associated with laryngeal malignancy: a systematic review and meta-analysis", Clin Gastroenterol Hepatol, 17(7), pp.1253~1264 (2019)
  21. Busch EL, "Gastroesophageal reflux disease and odds of head and neck squamous cell carcinoma in North Carolina", Laryngoscope, 126(5), pp.1091~1096 (2016)
  22. LeBlanc B, "Increased pharyngeal reflux in patients treated for laryngeal cancer: a pilot study", Otolaryngol Head Neck Surg, 153(5), pp.791~794 (2015)
  23. Sereg-Bahar M, "Higher levels of total pepsin and bile acids in the saliva as a possible risk factor for early laryngeal cancer", Radiol Oncol, 49(1), pp.59~64 (2015)
  24. Zhang D, "Gastroesophageal reflux and carcinoma of larynx or pharynx: a meta-analysis", Acta Otolaryngol, 134(10), pp.982~989 (2014)
  25. Coca-Pelaz A, "Relationship between reflux and laryngeal cancer", Head Neck, 35(12), pp.1814~1818 (2013)
  26. Langevin SM, "Gastric reflux is an independent risk factor for laryngopharyngeal carcinoma", Cancer Epidemiol Biomarkers Prev, 22(6), pp.1061~1068 (2013)
  27. 태경, "The Role of Laryngopharyngeal Reflux as a Risk Factor in Laryngeal Cancer: A Preliminary Report", Clinical and Experimental Otorhinolaryngology, 4(2), pp.101~104 (2011), 대한이비인후과학회
  28. Basseri B, "Heterotopic gastric mucosa (inlet patch) in a patient with laryngopharyngeal reflux (LPR) and laryngeal carcinoma: a case report and review of literature", Dis Esophagus, 22(4), pp.E1~E5 (2009)
  29. Ozlugedik S, "Is laryngopharyngeal reflux an important risk factor in the development of laryngeal carcinoma?", Eur Arch Otorhinolaryngol, 263(4), pp.339~343 (2006)
  30. Geterud A, "Hypopharyngeal acid exposure: an independent risk factor for laryngeal cancer?", Laryngoscope, 113(12), pp.2201~2205 (2003)
  31. Nilsson M, "No association between gastroesophageal reflux and cancers of the larynx and pharynx", Cancer Epidemiol Biomarkers Prev, 14(5), pp.1194~1197 (2005)
  32. Smit CF, "Effect of cigarette smoking on gastropharyngeal and gastroesophageal reflux", Ann Otol Rhinol Laryngol, 110(2), pp.190~193 (2001)
  33. Francis DO, "Reevaluation of gastroesophageal reflux disease as a risk factor for laryngeal cancer", Laryngoscope, 121(1), pp.102~105 (2011)
  34. Qadeer MA, "Gastroesophageal reflux and laryngeal cancer: causation or association? A critical review", Am J Otolaryngol, 27(2), pp.119~128 (2006)
  35. El-Serag HB, "Gastroesophageal reflux disease is a risk factor for laryngeal and pharyngeal cancer", Am J Gastroenterol, 96(7), pp.2013~2018 (2001)
  36. Kim SY, "Increased risk of larynx cancer in patients with gastroesophageal reflux disease from a national sample cohort", Clin Otolaryngol, 44(4), pp.534~540 (2019)
  37. Best AR, "Current indications for transnasal esophagoscopy: an american broncho-esophagological association survey", Ann Otol Rhinol Laryngol, 127(12), pp.926~930 (2018)
  38. 정은재, "The Role of Transnasal Esophagoscopy in ENT Office: A Prospective, Multicenter Study in Korea", Clinical and Experimental Otorhinolaryngology, 7(2), pp.123~125 (2014), 대한이비인후과학회[DOI]
  39. Velanovich V, "Endoscopic, endoluminal fundoplication for gastroesophageal reflux disease: initial experience and lessons learned", Surgery, 148(4), pp.646~653 (2010)
  40. Doustmohammadian N, "Is there any association between esophagogastric endoscopic findings and laryngeal cancer?", Am J Otolaryngol, 32(6), pp.490~493 (2011)
  41. Maldhure S, "Role of PH monitoring in laryngopharyngeal reflux patients with voice disorders", Iran J Otorhinolaryngol, 28(89), pp.377~383 (2016)
  42. Mosli M, "Prevalence and clinical predictors of LPR among patients diagnosed with GERD according to the reflux symptom index questionnaire", Saudi J Gastroenterol, 24(4), pp.236~241 (2018)
  43. Lechien JR, "Validity and reliability of the reflux symptom score", Laryngoscope, 130(3), pp.E98~E107 (2020)
  44. Lechien JR, "Validity and reliability of the reflux sign assessment", Ann Otol Rhinol Laryngol, 129(4), pp.313~325 (2020)
  45. Lechien JR, "Evaluation and management of laryngopharyngeal reflux disease: state of the art review", Otolaryngol Head Neck Surg, 160(5), pp.762~782 (2019)
  46. Hammer HF, "Reflux-associated laryngitis and laryngopharyngeal reflux: a gastroenterologist’s point of view", Dig Dis, 27(1), pp.14~17 (2009)
  47. Ford CN, "Evaluation and management of laryngopharyngeal reflux", JAMA, 294(12), pp.1534~1540 (2005)
  48. Hanson DG, "Role of esophageal pH recording in management of chronic laryngitis: an overview", Ann Otol Rhinol Laryngol Suppl, 184, pp.4~9 (2000)
  49. Postma GN, "Ambulatory pH monitoring methodology", Ann Otol Rhinol Laryngol Suppl, 184, pp.10~14 (2000)
  50. Hayat JO, "Pepsin in saliva for the diagnosis of gastro-oesophageal reflux disease", Gut, 64(3), pp.373~380 (2015)
  51. Na SY, "Optimal timing of saliva collection to detect pepsin in patients with laryngopharyngeal reflux", Laryngoscope, 126(12), pp.2770~2773 (2016)
  52. Johnston N, "Pepsin promotes proliferation of laryngeal and pharyngeal epithelial cells", Laryngoscope, 122(6), pp.1317~1325 (2012)
  53. Dy F, "Salivary pepsin lacks sensitivity as a diagnostic tool to evaluate extraesophageal reflux disease", J Pediatr, 177, pp.53~58 (2016)
  54. Hayat JO, "Objective detection of esophagopharyngeal reflux in patients with hoarseness and endoscopic signs of laryngeal inflammation", J Clin Gastroenterol, 48(4), pp.318~327 (2014)
  55. Yadlapati R, "Abilities of oropharyngeal pH tests and salivary pepsin analysis to discriminate between asymptomatic volunteers and subjects with symptoms of laryngeal irritation", Clin Gastroenterol Hepatol, 14(4), pp.535~542 (2016)
  56. Raja Nhari RM, "Detection of porcine pepsin in model cheese using polyclonal antibody-based ELISA", Food Addit Contam Part A Chem Anal Control Expo Risk Assess, 37(4), pp.561~567 (2020)
  57. Ju H, "Comparison of the structural characteristics of native collagen fibrils derived from bovine tendons using two different methods: modified acid-solubilized and pepsin-aided extraction", Materials (Basel), 13(2), pp.358~ (2020)
  58. Fortunato JE, "Pepsin in saliva as a biomarker for oropharyngeal reflux compared with 24-hour esophageal impedance", pH monitoring in pediatric patients, 2017, pp.29(2), e12936~
  59. Lee YJ, "Optimization of saliva collection and immunochromatographic detection of salivary pepsin for point-of-care testing of laryngopharyngeal reflux", Sensors (Basel), 20(1), pp.325~ (2020)
  60. Sereg-Bahar M, "Pepsin and bile acids in saliva in patients with laryngopharyngeal reflux: a prospective comparative study", Clin Otolaryngol, 40(3), pp.234~239 (2015)
  61. Guo Z, "Pepsin in saliva as a diagnostic marker for gastroesophageal reflux disease: a meta-analysis", Med Sci Monit, 24, pp.9509~9516 (2018)
  62. Du X, "The diagnostic value of pepsin detection in saliva for gastro-esophageal reflux disease: a preliminary study from China", BMC Gastroenterol, 17(1), pp.107~ (2017)
  63. Formanek M, "Comparison of impedance and pepsin detection in the laryngeal mucosa to determine impedance values that indicate pathological laryngopharyngeal reflux", Clin Transl Gastroenterol, 8(10), pp.e123~ (2017)
  64. Jiang A, "Immunohistochemical detection of pepsin in laryngeal mucosa for diagnosing laryngopharyngeal reflux", Laryngoscope, 121(7), pp.1426~1430 (2011)
  65. Johnston N, "Pepsin and carbonic anhydrase isoenzyme III as diagnostic markers for laryngopharyngeal reflux disease", Laryngoscope, 114(12), pp.2129~2134 (2004)
  66. Komatsu Y, "Hypopharyngeal pepsin and Sep70 as diagnostic markers of laryngopharyngeal reflux: preliminary study", Surg Endosc, 29(5), pp.1080~1087 (2015)
  67. Saritas Yuksel E, "Rapid salivary pepsin test: blinded assessment of test performance in gastroesophageal reflux disease", Laryngoscope, 122(6), pp.1312~1316 (2012)
  68. Knight J, "Sensitive pepsin immunoassay for detection of laryngopharyngeal reflux", Laryngoscope, 115(8), pp.1473~1478 (2005)
  69. Niu K, "Pepsin promotes laryngopharyngeal neoplasia by modulating signaling pathways to induce cell proliferation", PLoS One, 15(1), pp.e0227408~ (2020)
  70. Sasaki CT, "Biliary reflux as a causal factor in hypopharyngeal carcinoma: new clinical evidence and implications", Cancer, 125(20), pp.3554~3565 (2019)
  71. Doukas SG, "Biliary tumorigenic effect on hypopharyngeal cells is significantly enhanced by pH reduction", Cancer Med, 8(9), pp.4417~4427 (2019)
  72. Koufman JA, "The otolaryngologic manifestations of gastroesophageal reflux disease (GERD): a clinical investigation of 225 patients using ambulatory 24-hour pH monitoring and an experimental investigation of the role of acid and pepsin in the development of laryngeal injury", Laryngoscope, 101(4 Pt 2 Suppl 53), pp.1~78 (1991)
  73. Sharma N, "An analysis of persistent symptoms in acid-suppressed patients undergoing impedance-pH monitoring", Clin Gastroenterol Hepatol, 6(5), pp.521~524 (2008)
  74. Koufman JA, "Laryngopharyngeal reflux is different from classic gastroesophageal reflux disease", Ear Nose Throat J, 81(9 Suppl 2), pp.7~9 (2002)
  75. Piper DW, "pH stability and activity curves of pepsin with special reference to their clinical importance", Gut, 6(5), pp.506~508 (1965)
  76. Tutuian R, "Characteristics of symptomatic reflux episodes on acid suppressive therapy", Am J Gastroenterol, 103(5), pp.1090~1096 (2008)
  77. Poelmans J, "Paroxysmal laryngospasm: a typical but underrecognized supraesophageal manifestation of gastroesophageal reflux?", Dig Dis Sci, 49(11-12), pp.1868~1874 (2004)
  78. Sifrim D, "Review article: acidity and volume of the refluxate in the genesis of gastro-oesophageal reflux disease symptoms", Aliment Pharmacol Ther, 29(9), pp.1003~1017 (2007)
  79. Alimperti S, "CDH2 and CDH11 act as regulators of stem cell fate decisions", Stem Cell Res, 14(3), pp.270~282 (2015)
  80. Reichel O, "E-cadherin but not beta-catenin expression is decreased in laryngeal biopsies from patients with laryngopharyngeal reflux", Eur Arch Otorhinolaryngol, 265(8), pp.937~942 (2008)
  81. Galera-Ruiz H, "The cadherin-catenin complex in laryngeal squamous cell carcinoma", Eur Arch Otorhinolaryngol, 269(4), pp.1183~1188 (2012)
  82. Takeichi M, "Cadherins in cancer: implications for invasion and metastasis", Curr Opin Cell Biol, 5(5), pp.806~811 (1993)
  83. Johnston N, "Effect of pepsin on laryngeal stress protein (Sep70, Sep53, and Hsp70) response: role in laryngopharyngeal reflux disease", Ann Otol Rhinol Laryngol, 115(1), pp.47~58 (2006)
  84. Johnston N, "Cell biology of laryngeal epithelial defenses in health and disease: further studies", Ann Otol Rhinol Laryngol, 112(6), pp.481~491 (2003)
  85. Samuels TL, "Mucin gene expression in human laryngeal epithelia: effect of laryngopharyngeal reflux", Ann Otol Rhinol Laryngol, 117(9), pp.688~695 (2008)
  86. Forero-Quintero LS, "Membrane-anchored carbonic anhydrase IV interacts with monocarboxylate transporters via their chaperones CD147 and GP70", J Biol Chem, 294(2), pp.593~607 (2019)
  87. Mikulski RL, "Proton transfer in catalysis and the role of proton shuttles in carbonic anhydrase", Biochim Biophys Acta, 1804(2), pp.422~426 (2010)
  88. Tashian RE, "The carbonic anhydrases: widening perspectives on their evolution, expression and function", Bioessays, 10(6), pp.186~192 (1989)
  89. Belafsky PC, "Laryngopharyngeal reflux: the value of otolaryngology examination", Curr Gastroenterol Rep, 10(3), pp.278~282 (2008)
  90. Kannan KK, "Structure, refinement, and function of carbonic anhydrase isozymes: refinement of human carbonic anhydrase I", Ann N Y Acad Sci, 429, pp.49~60 (1984)
  91. Monti DM, "Insights into the role of reactive sulfhydryl groups of Carbonic Anhydrase III and VII during oxidative damage", J Enzyme Inhib Med Chem, 32(1), pp.5~12 (2017)
  92. Welch WJ, "Influence of molecular and chemical chaperones on protein folding", Cell Stress Chaperones, 1(2), pp.109~115 (1996)
  93. Wu K, "Protein folding while chaperone bound is dependent on weak interactions", Nat Commun, 10(1), pp.4833~ (2019)
  94. Freilich R, "Protein-protein interactions in the molecular chaperone network", Acc Chem Res, 51(4), pp.940~949 (2018)
  95. Johnston N, "Rationale for targeting pepsin in the treatment of reflux disease", Ann Otol Rhinol Laryngol, 119(8), pp.547~558 (2010)
  96. Johnston N, "Receptor-mediated uptake of pepsin by laryngeal epithelial cells", Ann Otol Rhinol Laryngol, 116(12), pp.934~938 (2007)
  97. Samuels TL, "Pepsin as a causal agent of inflammation during nonacidic reflux", Otolaryngol Head Neck Surg, 141(5), pp.559~563 (2009)
  98. Samuels TL, "Esophageal pepsin and proton pump synthesis in barrett’s esophagus and esophageal adenocarcinoma", Laryngoscope, 129(12), pp.2687~2695 (2019)
  99. Wood JM, "Does gene expression in laryngeal subsites differ between patients with laryngopharyngeal reflux and controls?", Clin Otolaryngol, 43(1), pp.158~163 (2018)
  100. Van Roon AH, "Impact of gastro-esophageal reflux on mucin mRNA expression in the esophageal mucosa", J Gastrointest Surg, 12(8), pp.1331~1340 (2008)
  101. Zhang F, "MicroRNA‑143‑3p suppresses cell growth and invasion in laryngeal squamous cell carcinoma via targeting the k‑Ras", Raf, ERK signaling pathway, pp.Int J Oncol, 2019[DOI]
  102. Nath K, "Proton-pump inhibitor overuse: a cautionary tale in misguided benefit", Intern Med J, 49(10), pp.1337~ (2019)
  103. Delshad SD, "Prevalence of gastroesophageal reflux disease and proton pump inhibitor-refractory symptoms", Gastroenterology, 158(5), pp.1250~1261 (2020)
  104. Eherer AJ, "Effect of pantoprazole on the course of reflux-associated laryngitis: a placebo-controlled double-blind crossover study", Scand J Gastroenterol, 38(5), pp.462~467 (2003)
  105. Noordzij JP, "Evaluation of omeprazole in the treatment of reflux laryngitis: a prospective, placebo-controlled, randomized, double-blind study", Laryngoscope, 111(12), pp.2147~2151 (2001)
  106. El-Serag HB, "Lansoprazole treatment of patients with chronic idiopathic laryngitis: a placebo-controlled trial", Am J Gastroenterol, 96(4), pp.979~983 (2001)
  107. Hu Q, "Proton pump inhibitors do not reduce the risk of esophageal adenocarcinoma in patients with Barrett’s esophagus: a systematic review and meta-analysis", PLoS One, 121(1), pp.e0169691~ (2017)
  108. Samuels T, "Local synthesis of pepsin in Barrett’s esophagus and the role of pepsin in esophageal adenocarcinoma", Ann Otol Rhinol Laryngol, 124(11), pp.893~902 (2015)
  109. Hvid-Jensen F, "Proton pump inhibitor use may not prevent high-grade dysplasia and oesophageal adenocarcinoma in Barrett’s oesophagus: a nationwide study of 9883 patients", Aliment Pharmacol Ther, 39(9), pp.984~991 (2014)
  110. Nason KS, "Gastroesophageal reflux disease symptom severity, proton pump inhibitor use, and esophageal carcinogenesis", Arch Surg, 146(7), pp.851~858 (2011)
  111. Lao-Sirieix P, "Effect of acid suppression on molecular predictors for esophageal cancer", Cancer Epidemiol Biomarkers Prev, 15(2), pp.288~293 (2006)
  112. Ten Kate RW, "Effect of high dose omeprazole on gastric pepsin secretion and serum pepsinogen levels in man", Eur J Clin Pharmacol, 35(2), pp.173~176 (1988)
  113. Hurley BP, "Pepsin triggers neutrophil migration across acid damaged lung epithelium", Sci Rep, 9(1), pp.13778~ (2019)
  114. Walentek P, "ATP4a is required for development and function of the Xenopus mucociliary epidermis: a potential model to study proton pump inhibitor-associated pneumonia", Dev Biol, 408(2), pp.292~304 (2015)
  115. Johnston N, "Pepsin: biomarker, mediator, and therapeutic target for reflux and aspiration", Ann N Y Acad Sci, 1434(1), pp.282~289 (2018)
  116. Bardhan KD, "Reflux revisited: advancing the role of pepsin", Int J Otolaryngol, 2012, pp.646901~ (2012)
  117. Strugala V, "The role of an alginate suspension on pepsin and bile acids: key aggressors in the gastric refluxate: does this have implications for the treatment of gastro-oesophageal reflux disease?", J Pharm Pharmacol, 61(8), pp.1021~1028 (2009)
  118. McGlashan JA, "The value of a liquid alginate suspension (Gaviscon Advance) in the management of laryngopharyngeal reflux", Eur Arch Otorhinolaryngol, 266(2), pp.243~251 (2009)
  119. Reimer C, "Randomised clinical trial: alginate (Gaviscon Advance) vs. placebo as add-on therapy in reflux patients with inadequate response to a once daily proton pump inhibitor", Aliment Pharmacol Ther, 43(8), pp.899~909 (2016)
  120. Wilkie MD, "Gaviscon® Advance alone versus co-prescription of Gaviscon® Advance and proton pump inhibitors in the treatment of laryngopharyngeal reflux", Eur Arch Otorhinolaryngol, 275(10), pp.2515~2521 (2018)
  121. Samuels TL, "Curcumin and anthocyanin inhibit pepsin-mediated cell damage and carcinogenic changes in airway epithelial cells", Ann Otol Rhinol Laryngol, 122(10), pp.632~641 (2013)

관련 논문AI추천

이 간행물의 다른 논문 (11건)