Schwab G P, Wetscher G J, Klinger A, Kreczy A, Ofner C, Berresheim U, Gadenstätter M
IInd Department of Surgery, University of Innsbruck, Austria.
Dig Dis Sci. 1997 Mar;42(3):608-15. doi: 10.1023/a:1018815613848.
Epithelial dysplasia in the gastric remnant is generally considered to have a positive predictive value for malignancy. Whether dysplasia progresses to carcinoma or whether both just have a common origin, is still a matter of controversy. The aim of the present study in rats was to investigate the natural history of epithelial lesions in the gastric remnant. A gastric resection was carried out in 50 male Wistar rats. Postoperatively the animals received N-methyl-N'-nitro-N-nitrosoguanidine orally. Gastroscopy was carried out monthly and biopsies were taken for histologic evaluation. The rats were killed after 12 months or if gastric cancer was found on gastroscopy. Twenty-four rats died postoperatively and were excluded from the study. A total of 228 gastroscopies was performed in the remaining 26 animals; 24 animals developed dysplastic lesions during the follow-up period. The rate of development of gastric cancer within one month increased with the stage of dysplasia at the previous examination (3% for mild, 48% for moderate, 100% for severe dysplasia). There was a strong correlation between the time period following gastric resection and grade of dysplasia and between the grade of dysplasia and development of cancer. Our study demonstrates that gastric stump cancer in rats develops from dysplastic lesions. A dysplasia-carcinoma sequence can therefore be assumed.
残胃上皮发育异常通常被认为对恶性肿瘤具有阳性预测价值。发育异常是会进展为癌，还是两者仅仅有共同的起源，仍然存在争议。本大鼠研究的目的是调查残胃上皮病变的自然病程。对50只雄性Wistar大鼠进行了胃切除术。术后给动物口服N-甲基-N'-硝基-N-亚硝基胍。每月进行一次胃镜检查，并取活检进行组织学评估。12个月后或胃镜检查发现胃癌时将大鼠处死。24只大鼠术后死亡，被排除在研究之外。其余26只动物共进行了228次胃镜检查；24只动物在随访期间出现了发育异常病变。前次检查时发育异常的程度越高，一个月内胃癌的发生率越高（轻度发育异常为3%，中度为48%，重度发育异常为100%）。胃切除术后的时间段与发育异常程度之间以及发育异常程度与癌症发生之间存在很强的相关性。我们的研究表明，大鼠残胃癌由发育异常病变发展而来。因此可以假定存在发育异常-癌序列。
