Aoyagi K, Kohfuji K, Yano S, Murakami N, Hori H, Terasaki Y, Takeda J, Shirouzu K
Department of Surgery, Kurume University School of Medicine, Japan.
Kurume Med J. 1999;46(3-4):167-70. doi: 10.2739/kurumemedj.46.167.
It is now accepted that the incidence of esophageal carcinoma is highest in the middle thoracic region. Esophageal carcinoma after gastrectomy, however, has a tendency to develop in the lower region. This study was designed to investigate the role of reflux of gastroduodenal juice in the genesis of carcinoma in the esophagus. We found a possible correlation between the development of esophageal carcinoma and gastrectomy, related to alkaline reflux into the esophagus. To elucidate this correlation, the role of alkaline reflux of duodenal contents in the development of esophageal squamous cell carcinoma was investigated in Wister rats. Gastrectomized rats with regurgitation of duodenal contents into the esophagus were not administered any carcinogen and were sacrificed some at the end of 8 weeks and others at 50 weeks for pathological examination. Hyperplasia was found in rats at 8 weeks, and the esophageal squamous cell carcinoma was found in rats at 50 weeks. The carcinomas were found exclusively in the area of the reflux esophagitis and were accompanied by severe dysplasia. These results suggested that alkaline reflux of duodenal contents was strongly correlated to the development of the esophageal squamous cell carcinoma.
目前公认食管癌的发病率在胸段中部最高。然而，胃切除术后的食管癌有在较低部位发生的倾向。本研究旨在探讨胃十二指肠液反流在食管癌发生中的作用。我们发现食管癌的发生与胃切除术之间可能存在关联，这与碱性反流至食管有关。为阐明这种关联，在Wistar大鼠中研究了十二指肠内容物碱性反流在食管鳞状细胞癌发生中的作用。将十二指肠内容物反流至食管的胃切除大鼠未给予任何致癌物，并在8周结束时处死一些大鼠，在50周时处死另一些大鼠进行病理检查。在8周龄的大鼠中发现了增生，在50周龄的大鼠中发现了食管鳞状细胞癌。这些癌仅在反流性食管炎区域发现，并伴有严重的发育异常。这些结果表明十二指肠内容物的碱性反流与食管鳞状细胞癌的发生密切相关。
