title: Exposure to gastric juice may not cause adenocarcinogenesis of the esophagus.
abstract: OBJECTIVE
  To determine the effects of gastric juice on the development of esophageal adenocarcinoma (EAC).
  
  
  METHODS
  A animal model of duodenogastroesophageal reflux was established in Sprague-Dawley rats undergoing esophagoduodenostomy. The development of EAC and forestomach adenocarcinoma was investigated 40 wk after the treatment. Intraluminal pH and bile of the forestomach were measured.
  
  
  RESULTS
  There were no significant differences in pH (t = 0.117, P = 0.925) or bile (χ² = 0.036, P = 0.85) in the forestomach before and 40 wk after esophagoduodenostomy. There were also no significant differences between the model and controls during esophagoduodenostomy or 40 wk after esophagoduodenostomy. The incidence of intestinal metaplasia (88%) and intestinal metaplasia with dysplasia and adenocarcinoma (28%) in the esophagus in the model was higher than in the controls 40 wk after surgery (χ² = 43.06, P < 0.001 and χ² = 9.33, P = 0.002, respectively) and in the forestomach in the model (χ² = 32.05, P < 0.001 and χ² = 8.14, P = 0.004, respectively). The incidence rates of inflammation in the esophagus and forestomach were 100% and 96%, respectively (χ² = 1.02, P = 0.31) in the model, which was higher than in the esophageal control (6.8%) (χ² = 42.70, P < 0.001).
  
  
  CONCLUSIONS
  Gastric juice exposure may not cause intestinal metaplasia with dysplasia or adenocarcinoma of the forestomach and may not be related to EAC.
authors.affiliation: Department of Gastroenterology, the 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: Lian-Feng
authors.initials: LF
authors.lastname: Zhang
authors.forename: Yong-Zhong
authors.initials: YZ
authors.lastname: Chen
authors.forename: Jun
authors.initials: J
authors.lastname: Gong
mesh_terms: D000230:Adenocarcinoma / Q000209:etiology* / Q000473:pathology; D000818:Animals; D001471:Barrett Esophagus / Q000209:etiology / Q000473:pathology; D001646:Bile / Q000378:metabolism; D004195:Disease Models, Animal; D004938:Esophageal Neoplasms / Q000209:etiology* / Q000473:pathology; D004947:Esophagus / Q000601:surgery; D005260:Female; D005750:Gastric Juice / Q000378:metabolism*; D005764:Gastroesophageal Reflux; D006863:Hydrogen-Ion Concentration; D007249:Inflammation; D007422:Intestines / Q000473:pathology; D008297:Male; D008679:Metaplasia; D051381:Rats; D017207:Rats, Sprague-Dawley; D013270:Stomach / Q000473:pathology; D013997:Time Factors
keywords: Esophageal adenocarcinoma; Gastric juice; Gastroesophageal reflux; Intestinal metaplasia; Pathogenesis