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Are the nitrites important in a genesis of the adenocarcinoma associated to the Barrett esophagus?

BACKGROUND: Barrett's esophagus is a complication of gastroesophageal reflux and predisposes to adenocarcinoma of the esophagogastric transition and several factors have been related to its pathogenesis. AIM: To evaluated the genesis of adenocarcinoma associated with Barrett's esophagus in an experimental model of duodenogastroesophageal reflux with the additional ingestion of sodium nitrite METHODS: Sixty male Wistar rats were divided into four groups. Twenty of these animals served as controls (10 animals ingesting only water and 10 ingesting water plus a solution of sodium nitrite), while the remaining 40 animals were submitted to side-to-side duodenogastroesophageal anastomosis (20 animals ingesting only water and 20 ingesting water plus the sodium nitrite solution). The occurrence of esophagitis, metaplasia, dysplasia, Barrett's esophagus associated with adenocarcinoma were analyzed. The Vienna classification for dysplasia and adenocarcinoma was used in the analysis of results. RESULTS: After 42 weeks of observation, Barrett's esophagus was found in 26.3% (5/19) of the animals only submitted to surgery compared to 72.3% (13/18) of the animals in the group submitted to surgery and given nitrites. Six cases of adenocarcinoma (33.3%) were also found in this latter group. Categories 2, 3 and 5 of the Vienna classification were only found in animals submitted to surgery plus sodium nitrite (66.7%). CONCLUSION: The ingestion of sodium nitrite associated with duodenogastroesophageal reflux plays an important role in the genesis of adenocarcinoma associated with Barrett's esophagus.

Duodenogastric reflux; Nitrites; Barrett Esophagus; Adenocarcinoma


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