[Carcinogenicity of duodenogastric reflux juice in patients undergoing gastrectomy].
OBJECTIVE
To determine the carcinogenic potential of reflux juice from patients undergoing remote gastrectomy and to clarify the relationship between duodenogastric reflux and gastric stump cancer.


METHODS
A total of 37 reflux juice samples (13 Billroth I, 24 Billroth II) were used. A two-stage transformation assay using BALB/c 3T3 cells was carried out to test the initiating or promoting activity of the samples.


RESULTS
11.1% reflux samples showed initiating activities, whereas 47.4% samples enhanced the MNNG-initiating cell transformation, suggesting that duodenogastric reflux juice might possess tumor-promoter activity (P < 0.05). There was no difference in initiating activities of the samples irrespective of surgical procedures (P > 0.05). Billroth II samples exhibited stronger tumor-promoter activity than Billroth I samples (P < 0.05), in accordance with many epidemic findings that this cancer preferred to Billroth II procedure. The promoter activities were well correlated with the histological changes of the stomas (r(s) = 0.625, P < 0.01), but both their cytotoxicities and initiating activities failed to show this correlation.


CONCLUSIONS
The duodenogastric reflux juice from patients undergoing remote gastrectomy has tumor-promoting activity on initiating activity. It is suggested that tumor-promoting potential should be responsible for the high incidence of gastric carcinoma in the patients undergoing remote gastrectomy. Thus a direct evidence for the etiology of gastric stump carcinoma is provided.
Ma
Z
Z
Department of General Surgery, First Hospital, Dalian Medical University, Dalian 116011, China.
Wang
Z
Z
Zhang
J
J
D000328:Adult; D000368:Aged; D000818:Animals; D041702:BALB 3T3 Cells; D002471:Cell Transformation, Neoplastic; D004383:Duodenogastric Reflux / Q000150:complications / Q000473:pathology*; D005260:Female; D005743:Gastrectomy; D018530:Gastric Stump / Q000473:pathology*; D005756:Gastritis / Q000473:pathology*; D006801:Humans; D008297:Male; D051379:Mice; D008807:Mice, Inbred BALB C; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000209:etiology*