Duodenoesophageal reflux and the development of esophageal adenocarcinoma in rats

Surgery. 1992 May;111(5):503-10.


Background: The carcinogenic effect of duodenoesophageal reflux, gastroesophageal reflux, and nitrosamines was studied in the rat esophagus.

Methods: Twenty male Sprague-Dawley rats underwent esophagogastroplasty to produce gastroesophageal reflux and 60 underwent duodenoesophageal anastomosis to produce duodenoesophageal reflux. Forty-three animals underwent no operation and acted as controls. Carcinogens known to produce squamous tumors in the rat esophagus (2,6-dimethylnitrosomorpholine [DMNM] or methyl-n-amylnitrosamine [MNAN]) were tested in each group.

Results: The rate of squamous carcinoma was 25% for rats with DMNM alone, 30% for rats with MNAN alone, and 20% for rats with induced gastroesophageal reflux plus DMNM. The rate of malignant change rose to 80% in rats with induced duodenoesophageal reflux and DMNM and 67% with duodenoesophageal reflux and MNAN. With duodenoesophageal reflux, 50% of tumors were adenocarcinoma, in contrast to 100% squamous differentiation of tumors in rats given the carcinogens with esophagogastroplasty or no operation.

Conclusion: The presence of duodenoesophageal reflux increased the frequency and changed the histologic type of esophageal cancer in nitrosamine-treated rats. This indicates that duodenoesophageal reflux plays a role in the development of esophageal adenocarcinoma.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adenocarcinoma / chemically induced
  • Adenocarcinoma / etiology*
  • Adenocarcinoma / pathology
  • Animals
  • Carcinogens
  • Carcinoma, Squamous Cell / chemically induced
  • Carcinoma, Squamous Cell / etiology*
  • Carcinoma, Squamous Cell / pathology
  • Duodenal Diseases / complications*
  • Esophageal Neoplasms / chemically induced
  • Esophageal Neoplasms / etiology*
  • Esophageal Neoplasms / pathology
  • Gastroesophageal Reflux / complications*
  • Male
  • Nitrosamines
  • Papilloma / chemically induced
  • Papilloma / etiology*
  • Papilloma / pathology
  • Polyps / chemically induced
  • Polyps / etiology*
  • Polyps / pathology
  • Rats
  • Rats, Inbred Strains


  • Carcinogens
  • Nitrosamines
  • N-amyl-N-methylnitrosamine
  • N-nitroso-2,6-dimethylmorpholine