Fujimura T
Second Department of Surgery, School of Medicine, Kanazawa University, Japan.
Nihon Geka Gakkai Zasshi. 1991 Aug;92(8):933-9.
The present study was designed to investigate which fraction of duodenal contents was responsible for gastric carcinogenesis, bile or pancreaticoduodenal juice. A series of 61 male Wistar rats were subjected to one of following four operative procedures: total reflux (TR, n = 17), bile reflux (BR, n = 8), or pancreaticoduodenal reflux (PDR, n = 16), and simple laparotomy (control, n = 20). Fifty weeks after operations the animals were sacrificed. The incidence of gastric adenocarcinoma was 7/17 (41%) in TR group, 2/8 (25%) in BR group, 0/16 (0%) in PDR group, and 0/20 (0%) in control group. The incidence of cancer in the both TR and BR groups were significantly higher than PDR and control groups, respectively. Histologically, lesions of gastric cancers showed tubular adenocarcinoma or mucinous adenocarcinoma. There was a significant difference in the intragastric pH between the first three reflux groups and control group. The concentrations of the total bile acids of the both TR and BR groups were significantly higher than PDR and control groups, respectively. These results suggested that duodenogastric reflux induces adenocarcinoma in the rat gastric mucosa and bile rather than pancreatico-duodenal juice is related to increased risk for gastric cancer.
本研究旨在探究十二指肠内容物的哪一部分（胆汁或胰十二指肠液）会导致胃癌发生。61只雄性Wistar大鼠接受以下四种手术操作之一：全反流（TR，n = 17）、胆汁反流（BR，n = 8）、胰十二指肠反流（PDR，n = 16），以及单纯剖腹术（对照组，n = 20）。术后50周处死动物。TR组胃腺癌发生率为7/17（41%），BR组为2/8（25%），PDR组为0/16（0%），对照组为0/20（0%）。TR组和BR组的癌症发生率分别显著高于PDR组和对照组。组织学上，胃癌病变表现为管状腺癌或黏液腺癌。前三个反流组与对照组的胃内pH值存在显著差异。TR组和BR组的总胆汁酸浓度分别显著高于PDR组和对照组。这些结果表明，十二指肠-胃反流可诱发大鼠胃黏膜腺癌，且与胃癌风险增加相关的是胆汁而非胰十二指肠液。
