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目的：通过动物实验研究胃液及十二指肠内容物反流对食管肿瘤发生过程的影响。方法：通过不同手术方式制作３种动物模型：单纯胃食管反流（Ｇ组），单纯十二指肠食管反流（Ｄ组），十二指肠、胃混合食管反流（ＤＧ组）及无反流对照组（Ｃ组）。术后均注射食管致癌剂甲基戊基亚硝胺（ＭＡＮＡ），于２６ 周取出食管进行大体及光镜下形态学观察。结果：各反流组出现严重食管粘膜损害，病变较对照组明显加重且发生率高，病变严重程度Ｄ组＞ ＤＧ组＞ Ｇ组。食管乳头状瘤发生率，Ｄ组４０．９％ ，ＤＧ组２１．７％ ，Ｇ组５．６％ ，Ｃ组０％ ，各组之间相比均有显著差异（Ｐ＜ ０．０５）。Ｄ组及ＤＧ组共发现７ 例柱状上皮化生及６ 例异型增生，Ｄ组发现１ 例食管下段腺癌，Ｇ，Ｃ组未发现此病理改变。结论：胃液及十二指肠内容物无论单独或混合反流至食管均有加重致癌剂诱发大鼠食管肿瘤的作用，十二指肠内容物的作用较胃液更强，说明十二指肠食管反流可能对反流性食管炎并发食管肿瘤具有更重要的意义。
Objective: To study the effect of reflux of gastric juice and duodenal contents on the development of esophageal tumors in animal experiments. METHODS: Three animal models were made by different surgical methods: simple gastroesophageal reflux (group G), simple duodenoesophageal reflux (group D), duodenal and gastric mixed esophageal reflux (DG group) and No reflux control group (C group). All patients were injected with esophageal carcinogen Methyl-N-nitrosamine (MANA) after surgery. The esophagus was removed at 26 weeks for gross and light microscopy. RESULTS: Severe esophageal mucosal lesions were found in the regurgitant groups. The lesions were significantly heavier than the control group and the incidence was high. The severity of the lesions was in group D> DG> group G. The incidence of esophageal papilloma was 40.9% in group D, 21.7% in DG group, 5.6% in group G, and 0% in group C. There was a significant difference between the groups (P<0.05). . In group D and group DG, 7 cases of columnar metaplasia and 6 cases of dysplasia were found. In group D, 1 case of lower esophageal adenocarcinoma was found. No pathological changes were found in groups G and C. CONCLUSIONS: Gastric juice and duodenal contents, either alone or in combination, refluxed to the esophagus, have increased effects of carcinogen-induced esophageal neoplasms in the rat, and the duodenal contents have a stronger effect than gastric juice, indicating that the duodenal esophagus Retrograde reflux may have more important implications for reflux esophagitis complicated by esophageal cancer.