Ulceration as a possible link between duodenogastric reflux and neoplasms in the stomach of rats.
BACKGROUND
Duodenogastric reflux predisposes to gastric cancer. This study investigates whether ulceration induced by duodenogastric reflux is associated with the development of neoplasms in the stomach.


METHODS
In a rat experiment, duodenal fluid was directed into the corpus (jejunal reflux) or through the pylorus into the antrum (pyloric reflux). Sham-operated animals served as controls. The animals were sacrificed after 24, 36, or 52 weeks.


RESULTS
Ulcerations and neoplasms occurred more frequently in the corpus than in the antrum. In the corpus, ulceration was observed significantly more often in animals with jejunal reflux (62, 55, and 53% at 24, 36, and 52 weeks, respectively) than in animals with pyloric reflux (15, 21, and 30%). The incidence of neoplasm in the corpus increased significantly with time from 38% at 24 weeks to 89% at 52 weeks in animals with jejunal reflux and from 12 to 33% in animals with pyloric reflux. Ulceration and neoplasms shared location in the corpus adjacent to the gastrojejunostomy and by 24 weeks, all but one neoplasm in the jejunal reflux and one in pyloric reflux groups occurred adjacent to ulceration. In the antrum, 37% of the animals had a prepyloric ulceration after 24 weeks of pyloric reflux and only one of these animals had a neoplasm. By 52 weeks 20% of animals with pyloric reflux had a neoplasm that appeared in the prepyloric area.


CONCLUSIONS
Ulceration and neoplasm occurred at the same sites in the stomach, and ulcerations preceded the development of neoplasms in the antrum and very likely in the corpus. The results suggest that ulceration plays an important role in the genesis of neoplasms in the stomach and that the vulnerability to duodenogastric reflux is more pronounced in the corpus than in the antrum mucosa.
Øvrebø
Kjell K
KK
Surgical Research Laboratory, Department of Surgery, University of Bergen, Haukeland Hospital, Norway. Kjell.Ovrebo@kir.uib.no
Aase
Steinar
S
Grong
Ketil
K
Viste
Asgaut
A
Svanes
Knut
K
Sørbye
Halfdan
H
D000230:Adenocarcinoma / Q000209:etiology / Q000473:pathology; D000818:Animals; D002455:Cell Division; D004383:Duodenogastric Reflux / Q000150:complications*; D005753:Gastric Mucosa / Q000473:pathology; D008297:Male; D051381:Rats; D013274:Stomach Neoplasms / Q000209:etiology* / Q000473:pathology; D013276:Stomach Ulcer / Q000150:complications* / Q000209:etiology