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 divided into three groups:low-pH group (group A),highpH group (group B) and a sham-operated group as a control (group C) (n=30 rats in each group).The incidence 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 low-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.
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.
基金
Supported by the Key Project of Clinical Medicine,Ministry of Health,No. 20012130
