Salmon R J, Merle S, Zafrani B, Decosse J J, Sherlock P, Deschner E E
Jpn J Cancer Res. 1985 Mar;76(3):167-72.
The effect of gastrectomy and duodenal reflux on gastric carcinogenesis was studied because gastrectomized patients may be considered at "high risk" for the development of gastric stump cancer. Wistar rats received N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) (83 mg/liter) ad libitum in the drinking water for either four, eight, or twelve weeks. A control group received tap water. After MNNG administration animals were antrectomized. Antrectomy was not performed in a control group. Bowel continuity was restored either with a Billroth II (BIL) or with a ROUX en Y (ROUX) procedure. Duodenogastric reflux is possible after the BIL but not after the ROUX procedure. Eight months after the beginning of the experiment the stomachs of the animals were studied. In both operated and unoperated animals, the number of cancers observed was significantly related to the duration of MNNG administration. Animals receiving MNNG plus the BIL procedure had a significantly higher number of anastomotic cancers than the ROUX animals, indicating that duodenogastric reflux played a promotional role in gastric carcinogenesis. Three BIL gastrectomized rats not receiving the carcinogen had an adenocarcinoma on the anastomotic line further emphasizing the risk attached to the duodeno-gastric reflux.
由于胃切除患者可能被视为发生残胃癌的“高危”人群，因此研究了胃切除术和十二指肠反流对胃癌发生的影响。Wistar大鼠在饮用水中随意饮用含N-甲基-N'-硝基-N-亚硝基胍（MNNG）（83毫克/升）的水，持续4周、8周或12周。对照组饮用自来水。给予MNNG后，对动物进行胃窦切除术。对照组未进行胃窦切除术。采用毕罗Ⅱ式（BIL）或 Roux-en-Y（ROUX）手术恢复肠道连续性。BIL手术后可能发生十二指肠胃反流，但ROUX手术后不会。实验开始8个月后，对动物的胃进行研究。在手术和未手术的动物中，观察到的癌症数量与MNNG给药时间显著相关。接受MNNG加BIL手术的动物吻合口癌的数量明显高于ROUX手术的动物，表明十二指肠胃反流在胃癌发生中起促进作用。三只未接受致癌物的BIL胃切除大鼠在吻合线上发生了腺癌，进一步强调了十二指肠胃反流的风险。
