Aim: To investigate the effects of the different pH value gastric and duodenal reflux contents on the esophageal adenocarcinogenesis. Methods: A total of 90 SD rats were randomly divided into three groups (n = 30). Two types of surgical procedures were performed by esophagoduodenostomy to produce duodeno-gastro-esophageal reflux in low pH value and in high pH value respectively, and group of sham operation was used as control. Esophageal mucosa pathological changes were examined 40 weeks after surgery. Results: Rat model of the esophageal adenocarcinoma( EA) induced by the duo-denogastric juice reflux of different pH values were established successfully. The incidence of esophagitis, Barrett' s esophagus, atypical hyperplasia and EA of EDB group was 100. 0% , 82. 6% , 52. 1% , and 39. 0% respectively, 96. 0% , 88.0% ,20.0% and 8.0% in EDA group,13.7% ,0,0,and 0 in control group. There were significant differences among three groups in the incidence of esophagitis, Barrett' s esophagus, atypical hyperplasia and EA (x2 =57. 290,53. 120, 21. 390,and 17. 230,P <0. 001). Conclusion:The gastric acid reduces the risk of atypical hyperplasia and EA,and pancreatic juice increases the risk of atypical hyperplasia and EA induced by duodeno-gastro-esophageal reflux.%目的:探讨不同pH值的十二指肠胃混合食管反流对食管腺癌发生的影响.方法:分别将食管于距幽门远端I和2 cm处与十二指肠吻合,建立低和高pH值十二指肠胃混合食管反流SD大鼠模型(EDA组和EDB组),每组各30只,设立假手术组30只作为对照.分别观察造模40周后动物食管炎、Barrett's食管、腺体不典型增生和食管腺癌的发生率.结果:成功建立pH值不同的十二指肠胃混合食管反流SD大鼠模型,模型动物40周后均发生食管炎、Barrett'8食管、腺体不典型增生和食管腺癌.对照组、EDA组和EDB组比较:食管炎发生率分别为13.7%、96.0%和100.0%(χ2=57.290,P<0.001),Barrett's 食管发生率分别为0、88.0%和82.6%(χ2=53.120,P<0.001),腺体不典型增生发生率分别为0、20.0%和52.1%(χ2=20.390,P<0.001),食管腺癌发生率分别为0、8.0%和39.0%(χ2=17.230,P<0.001).结论:胃酸反流与食管炎发生有关,胰液反流增加腺体不典型增生和食管腺癌的发生率.
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