Department of Gastroenterology, First Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.
World J Gastroenterol. 2011 Jul 7;17(25):3060-5. doi: 10.3748/wjg.v17.i25.3060.
To determine the effects of duodenogastric juice pH on the development of esophageal adenocarcinoma (EAC).
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), high-pH 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.
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.
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.
确定十二指肠胃胆汁 pH 值对食管腺癌 (EAC) 发展的影响。
使用接受食管十二指肠吻合术 (ED) 的 Sprague-Dawley (SD) 大鼠建立十二指肠胃食管反流动物模型。研究暴露于不同 pH 值十二指肠胃胆汁的大鼠中 EAC 的发展情况。将大鼠分为三组：低 pH 值组（A 组）、高 pH 值组（B 组）和假手术组作为对照（C 组）（每组 30 只大鼠）。在治疗后 40 周观察食管炎、Barrett 食管（BE）、异型增生肠上皮化生和 EAC 的发生率。
40 周后，A 组和 B 组的食管炎、BE、异型增生肠上皮化生和 EAC 的发生率均高于对照组（P < 0.01），分别为 96%和 100%（P > 0.05）、88%和 82.4%（P > 0.05）、20%和 52.1%（P < 0.05）和 8%和 39%（P < 0.05）。
非酸性反流物增加异型增生肠上皮化生和 EAC 的发生，而低 pH 值胃液在存在十二指肠液时具有保护作用。非酸性反流在 BE 向癌症的进展中尤为重要。因此，控制十二指肠反流可能是预防 EAC 的重要措施。
