Duodenoesophageal reflux and the development of esophageal adenocarcinoma in rats.
BACKGROUND
The carcinogenic effect of duodenoesophageal reflux, gastroesophageal reflux, and nitrosamines was studied in the rat esophagus.


METHODS
Twenty male Sprague-Dawley rats underwent esophagogastroplasty to produce gastroesophageal reflux and 60 underwent duodenoesophageal anastomosis to produce duodenoesophageal reflux. Forty-three animals underwent no operation and acted as controls. Carcinogens known to produce squamous tumors in the rat esophagus (2,6-dimethylnitrosomorpholine [DMNM] or methyl-n-amylnitrosamine [MNAN]) were tested in each group.


RESULTS
The rate of squamous carcinoma was 25% for rats with DMNM alone, 30% for rats with MNAN alone, and 20% for rats with induced gastroesophageal reflux plus DMNM. The rate of malignant change rose to 80% in rats with induced duodenoesophageal reflux and DMNM and 67% with duodenoesophageal reflux and MNAN. With duodenoesophageal reflux, 50% of tumors were adenocarcinoma, in contrast to 100% squamous differentiation of tumors in rats given the carcinogens with esophagogastroplasty or no operation.


CONCLUSIONS
The presence of duodenoesophageal reflux increased the frequency and changed the histologic type of esophageal cancer in nitrosamine-treated rats. This indicates that duodenoesophageal reflux plays a role in the development of esophageal adenocarcinoma.
Attwood
S E
SE
Department of Surgery, Creighton University School of Medicine, Omaha, Neb.
Smyrk
T C
TC
DeMeester
T R
TR
Mirvish
S S
SS
Stein
H J
HJ
Hinder
R A
RA
D000230:Adenocarcinoma / Q000139:chemically induced / Q000209:etiology* / Q000473:pathology; D000818:Animals; D002273:Carcinogens; D002294:Carcinoma, Squamous Cell / Q000139:chemically induced / Q000209:etiology* / Q000473:pathology; D004378:Duodenal Diseases / Q000150:complications*; D004938:Esophageal Neoplasms / Q000139:chemically induced / Q000209:etiology* / Q000473:pathology; D005764:Gastroesophageal Reflux / Q000150:complications*; D008297:Male; D009602:Nitrosamines; D010212:Papilloma / Q000139:chemically induced / Q000209:etiology* / Q000473:pathology; D011127:Polyps / Q000139:chemically induced / Q000209:etiology* / Q000473:pathology; D051381:Rats; D011919:Rats, Inbred Strains
D002273:Carcinogens; D009602:Nitrosamines; C025033:N-amyl-N-methylnitrosamine; C014130:N-nitroso-2,6-dimethylmorpholine