title: Effects of refluxate pH values on duodenogastroesophageal reflux-induced esophageal adenocarcinoma.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Gastroenterology, First Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China. cpzxczzc2004@yahoo.com.cn
authors.forename: Peng
authors.initials: P
authors.lastname: Cheng
authors.forename: Jian-Sheng
authors.initials: JS
authors.lastname: Li
authors.forename: Jun
authors.initials: J
authors.lastname: Gong
authors.forename: Lian-Feng
authors.initials: LF
authors.lastname: Zhang
authors.forename: Rong-Zhong
authors.initials: RZ
authors.lastname: Chen
mesh_terms: D000230:Adenocarcinoma / Q000209:etiology* / Q000473:pathology; D000818:Animals; D004383:Duodenogastric Reflux / Q000150:complications*; D004938:Esophageal Neoplasms / Q000209:etiology* / Q000473:pathology; D004947:Esophagus / Q000033:anatomy & histology / Q000473:pathology; D005750:Gastric Juice / Q000737:chemistry*; D005764:Gastroesophageal Reflux / Q000150:complications*; D006863:Hydrogen-Ion Concentration; D008297:Male; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley