摘要
AIM: To determine whether study on the carcinogenic potential of reflux juice from patients with remote gastrectomy could clarify the inherent relationship between duodenal reflux and gastric stump cancer. METHODS: A total of 37 reflux juice samples (13 Billroth I, 24 Billroth II) were employed in the present study. A two-stage transformation assay using BALB/c 3T3 cells was carried out to test the initiating or promoting activity of these samples. RESULTS: Two of 18 (11.1%) reflux samples exerted initiating activities, whereas 9/19 (47.4%) samples enhanced the MNNG-initiating cell transformation, suggesting the duodenal reflux juice might more frequently possess the tumor-promoter activity (P = 0.029). In addition, there was no difference in initiating activities of the samples irrespective of surgical procedures (P = 0.488), while Billroth II samples exhibited stronger tumor-promoter activity than Billroth I samples (P = 0.027). Furthermore, the promoter activities were well correlated with the histological changes of the stomas (r(s) = 0.625, P = 0.004), but neither their cytotoxicities nor initiating activities had this correlation (Probabilities were 0.523 and 0.085, respectively). CONCLUSION: The duodenal reflux juice from patients with remote postgastrectomy did have carcinogenic potential, and suggested that tumor-promoting activity should principally account for the high incidence of gastric cancer in gastrectomy patients. In contrast, it is difficult to explain the high stump-cancer incidence with the N-nitroso compounds theory-a popular theory for the intact stomach carcinogenesis, and it seemed to be justified to focus chemo-prevention of this cancer on the tumor-promoting potential of reflux juice.
AIM To determine, whether study on thecarcinogenic potential of reflux juice frompatients with remote gastrectomy could clarifythe inherent relationship between duodenalreflux and gastric stump cancer.METHODS A total of 37 reflux juice samples(13 Billroth T, 24 Billroth Ⅱ ) were employed inthe present study. A two- stage transformationassay using BALB/c 3T3 cells was carried out totest the initiating or promoting activity of thesesamples.RESULTS Two of 18 (11.1%) reflux samplesexerted initiating activities, whereas 9/19(47.4%) samples enhanced the MNNG-initiafingcell transformation, suggesting the duodenalreflux juice might more frequently possess thetumor-promoter activity (P = 0. 029). In addition,there was no difference in initiating activities ofthe samples irrespective of surgical procedures(P=0.488), while Billroth Ⅱ samples exhibitedstronger tumor-promoter activity than Billroth Ⅰsamples (P = 0.027). Furthermore, the promoteractivities were well correlated with thehistological changes of the stomas (rs = 0.625,P = 0.004), but neither their cytotoxicities norinitiating activities had this correlation( Probabilities were 0.523 and 0.085,respectively).CONCLUSION The duodenal reflux juice frompatients with remote postgastrectomy did havecarcinogenic potential, and suggested thattumor-promoting activity should principallyaccount for the high incidence of gastric cancerin gastrectomy patients. In contrast, it isdifficult to explain the high stump-cancerincidence with the 'N-nitroso compounds'theory-a popular theory for the intact stomachcarcinogenesis, and it seemed to be justified tofocus chemoprevention of this cancer on thetumor-promoting potential of reflux juice.
作者
Zhe Fu Ma~1 Zhong Yu Wang~1 Jun Ran Zhang~2 Peng Gong~1 Hai Long Chen~1 ~1Departrnent of General Surgery,First Hospital,Dalian Medical University,Dalian 116011,China ~2Department of Radiation Oncology,Massachusetts General Hospital and Harvard Medical School,Charlestown,MA 02129,USADr.Zhe Fu Ma graduated from Shanxi Medical College in 1993,nowPh.D.,M.D.in Department of Surgery,Dalian Medical University,majoring gastroenteric cancer,having 4 papers published.Correspondence to:Dr.Zhe Fu Ma.Department of General Surgery,First Hospital,Dalian Medical University,Dalian 116011,China Tel.0086-411-4720334
