Williamson R C, Bauer F L, Ross J S, Watkins J B, Malt R A
Gastroenterology. 1979 Jun;76(6):1386-92.
Since biliary excretion of metabolites might determine the pattern of intestinal neoplasms induced by azoxymethane, the number and distribution of tumors were studied in rats after pancreaticobiliary diversion to the mid small bowel. Pancreaticobiliary diversion was performed either immediately before the first of 16 weekly injections of azoxymethane or 10 days after the last. Seven months after pancreaticobiliary diversion, persistent ileal hyperplasia was manifested by higher levels of mucosal RNA and DNA compared with controls (34--102%: P less than 0.001), while there was little residual adaptation in the colon. Qualitative and quantitative analysis of fecal bile acids 6--26 wk after pancreaticobiliary diversion showed few differences. Pancreaticobiliary diversion doubled the incidence of colonic tumors, whether operation preceded (P less than 0.005) or followed (P less than 0.02) the course of azoxymethane. Suture-line tumors were common in the small bowel, particularly in the transposed duodenal stump. Despite intense ileal hyperplasia as a consequence of pancreaticobiliary diversion, the ileum remained resistant to chemical carcinogenesis. The potentiation of colonic neoplasms by pancreaticobiliary diversion probably depends on the stimulation of colonic mucosal proliferation.
由于代谢产物的胆汁排泄可能决定由氧化偶氮甲烷诱导的肠道肿瘤模式，因此在胰胆管转流至空肠中部的大鼠中研究了肿瘤的数量和分布。胰胆管转流在16次每周一次的氧化偶氮甲烷注射中的第一次注射前立即进行，或在最后一次注射后10天进行。胰胆管转流7个月后，回肠持续增生表现为黏膜RNA和DNA水平高于对照组（34% - 102%：P < 0.001），而结肠几乎没有残余适应性变化。胰胆管转流后6 - 26周粪便胆汁酸的定性和定量分析显示差异不大。无论手术在氧化偶氮甲烷给药过程之前（P < 0.005）还是之后（P < 0.02）进行，胰胆管转流均使结肠肿瘤的发生率加倍。缝线处肿瘤在小肠中很常见，特别是在移位的十二指肠残端。尽管胰胆管转流导致回肠强烈增生，但回肠对化学致癌仍具有抗性。胰胆管转流对结肠肿瘤的促进作用可能取决于对结肠黏膜增殖的刺激。
