Brief Article
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jul 7, 2011; 17(25): 3060-3065
Published online Jul 7, 2011. doi: 10.3748/wjg.v17.i25.3060
Effects of refluxate pH values on duodenogastroesophageal reflux-induced esophageal adenocarcinoma
Peng Cheng, Jian-Sheng Li, Jun Gong, Lian-Feng Zhang, Rong-Zhong Chen
Peng Cheng, Jian-Sheng Li, Lian-Feng Zhang, Rong-Zhong Chen, Department of Gastroenterology, First Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
Jun Gong, Department of Gastroenterology, Second Hospital of Xi’an Jiao Tong University, Xi’an 450052, Shanxi Province, China
Author contributions: Cheng P and Gong J contributed equally to this work; Cheng P, Gong J and Li JS designed the research; Cheng P performed the research; Zhan LF and Chen RZ provided reagents and analyzed the data; Cheng P wrote the paper.
Supported by the Key Project of Clinical Medicine, Ministry of Health, No. 20012130
Correspondence to: Dr. Peng Cheng, Department of Gastroenterology, First Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China. cpzxczzc2004@yahoo.com.cn
Telephone: +86-371-66295932 Fax: +86-371-66964992
Received: November 8, 2010
Revised: March 23, 2011
Accepted: March 30, 2011
Published online: July 7, 2011
Abstract

AIM: To determine the effects of duodenogastric juice pH on the development of esophageal adenocarcinoma (EAC).

METHODS: 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.

RESULTS: 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.

CONCLUSION: 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.

Keywords: Esophageal reflux; Esophageal adenocarcinoma; pH-metry; Pathogenesis