Effects of refluxate pH values on duodenogastroesophageal reflux-induced esophageal adenocarcinoma

作     者：Peng Cheng Jian-Sheng Li Jun Gong Lian-Feng Zhang Rong-Zhong Chen 

作者机构：Department of Gastroenterology First Hospitalof Zhengzhou University Zhengzhou 450052 Henan ProvinceChina Department of Gastroenterology Second Hospitalof Xi＇an Jiao Tong University Xi＇an 450052 Shanxi ProvinceChina 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2011年第17卷第25期

页      面：3060-3065页

核心收录：

学科分类：090502[农学-动物营养与饲料科学] 0905[农学-畜牧学] 08[工学] 09[农学] 0815[工学-水利工程] 

基　　金：Supported by the Key Project of Clinical Medicine Ministry of Health No. 20012130 

主　　题：Esophageal reflux Esophageal adenocar-cinoma pH-metry Pathogenesis 

摘      要：AIM： To determine the effects of duodenogastric juice pH on the development of esophageal adenocarcinoma （EAC）. METHODS： An animal model of duodenogastroesophageal reflux was established using Sprague-Dawley （SD） rats undergoing esophagoduodenostomy （ED）. The development of EAC was investigated in rats exposed to duodenogastric juice of different pH. The rats were di- vided into three groups： Iow-pH group （group A）, high- pH group （group B） and a sham-operated group as a control （group C） （n = 30 rats in each group）. The inci- dence of esophagitis, Barrett＇s esophagus （BE）, intestinal metaplasia with dysplasia and EAC was observed 40 wk after the treatment. RESULTS： The incidence rate of esophagitis, BE, intestinal metaplasia with dysplasia and EAC was higher in groups A and B compared with the control group after 40 wk （P 〈 0.01）, being 96% and 100% （P 〉 0.05）, 88% and 82.4% （P 〉 0.05）, 20% and 52.1% （P 〈 0.05）, and 8% and 39% （P 〈 0.05）, respectively. CONCLUSION： Non-acidic refluxate increases the occurrence of intestinal metaplasia with dysplasia and EAC while the Iow-pH gastric juice exerts a protective effect in the presence of duodenal juice. The non-acid reflux is particularly important in the progression from BE to cancer. Therefore, control of duodenal reflux may be an important prophylaxis for EAC.