Seto Y, Kobori O, Shimizu T, Morioka Y
First Department of Surgery, Faculty of Medicine, University of Tokyo, Japan.
Int J Cancer. 1991 Nov 11;49(5):758-63. doi: 10.1002/ijc.2910490521.
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 thoracic region. These studies suggest a possible correlation between the development of esophageal carcinoma and gastrectomy, i.e., 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 induced by N-amyl-N-methylnitrosamine (AMN) was investigated in Wistar rats. The animals were divided into 3 groups; gastrectomized rats with or without regurgitation of duodenal contents into the esophagus, and control rats without gastrectomy. All received low doses of AMN for 8 weeks and were subsequently killed for pathological examination. Esophageal squamous-cell carcinomas were found only in gastrectomized rats with regurgitation. The carcinomas were found exclusively in areas of reflux esophagitis and were accompanied by severe dysplasia. Our results indicate that alkaline reflux of duodenal contents strongly contributes to the development of 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倾向于在胸段下部发生。这些研究表明食管癌的发生与胃切除术之间可能存在关联，即十二指肠内容物碱性反流至食管。为了阐明这种关联，在Wistar大鼠中研究了十二指肠内容物碱性反流在N-戊基-N-甲基亚硝胺（AMN）诱导的食管鳞状细胞癌发生中的作用。动物被分为3组：有或无十二指肠内容物反流至食管的胃切除大鼠，以及未行胃切除术的对照大鼠。所有动物均接受低剂量AMN 8周，随后处死进行病理检查。食管鳞状细胞癌仅在有反流的胃切除大鼠中发现。这些癌仅在反流性食管炎区域发现，并伴有严重发育异常。我们的结果表明十二指肠内容物碱性反流对食管鳞状细胞癌的发生有强烈影响。
