Reflux of Duodenal Juice and Esophageal Carcinogenesis in Rats

Hiroyuki Sahara

Department of Surgery II, School of Medicine, Kanazawa University

This study was designed to investigate the role of duodenal and gastric juice reflux in the genesis of esophageal carcinoma. Male Wistar rats, weighing approximately 250 g, underwent surgery that resulted in duodenogastroesophageal reflux (DGER), duodenoesophageal reflux (DER), gastroesophageal reflux (GER), or no reflux (RY). Twelve rats underwent a sham operation (SO). The animals were fed a standard maintenance diet and received no carcinogens. The rats were killed and examined 50 weeks after surgery. Esophageal carcinoma was identified in 23 lesions in 20 cases. The incidence of esophageal carcinoma was 83% in the DGER group (n=12), 77% in the DER group (n=13), 0% in the GER group (n=16) , 0% in the RY group(n=11), and 0% in the SO group(n=12). Theincidencerates of carcinoma in both the DER and DGER groups were significantly higher than in the other groups (p<0.001). Pathologically, 16 lesions were adenocarcinoma (ADC), three were squamous cell carcinoma (SCC), and four were adenosquamous carcinoma (ASC)' Adenocarcinoma occurred near the anastomosis, whereas SCC and ASC occurred more proximally. Adenocarcinoma occurred within Barrertt's epithelium, whereas SCC and ASC occurred within squamous esophagitis. These findings suggest that duodenoesophageal reflux is associated with the development of Barrett's esophagus and adenocarcinoma and adenosquamous carcinoma and squamous cell carcinoma, while gastroesophageal reflux is not associated with the development of carcinoma.

Key words
esophagus, neoplasms, reflux esophagitis, Barrett's esophagus, duodenal juice

Reprint requests
Hiroyuki Sahara Department of Surgery II, School of Medicine, Kanazawa University
13-1 Takaramachi, Kanazawa, 920 JAPAN

Accepted
March 8, 1995

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