Development from chronic inflammation to Barrett’s adenocarcinoma is known as one of the inflammation-related carcinogenesis routes. at the proliferative zone progresses to dysplasia and finally adenocarcinoma and exogenous carcinogen is not necessary for cancer development. It is demonstrated that duodenal juice rather than gastric juice is essential to develop esophageal adenocarcinoma in not only rodent experiments but also clinical studies. Antireflux surgery and chemoprevention by proton pump inhibitors nonsteroidal anti-inflammatory drugs selective cyclooxygenase-2 inhibitors green tea retinoic acid and thioproline showed preventive effects on the development of Barrett’s adenocarcinoma in rodent models but it remains controversial whether antireflux surgery could regress BE and prevent esophageal cancer in clinical observation. The Chemoprevention for Barrett’s Esophagus Trial (CBET) a phase IIb multicenter randomized double-masked study using celecoxib in patients with Barrett’s dysplasia failed to prove to prevent progression of dysplasia to cancer. The AspECT (Aspirin Esomeprazole Chemoprevention Trial) a large multicenter phase III randomized trial to evaluate the effects of esomeprazole and/or aspirin on the rate of progression to high-grade dysplasia or adenocarcinoma in patients with BE is now ongoing. investigated whether gastroesophageal or duodenoesophageal reflux influences the prevalence and differentiation of induced esophageal cancer in nitrosamine-treated rats [5]. They reported that Nepicastat the rate of squamous carcinoma was 25-30% for rats with either DMNM or MNAN alone and 20% for rats with induced gastroesophageal reflux plus DMNM while the rate of malignant change rose up to 67-80% buy Nepicastat in rats with induced duodenoesophageal reflux plus either nitrosamine. With duodenoesophageal reflux 50 of tumors were adenocarcinoma in contrast to 100% squamous differentiation of tumors in rats given the carcinogens with esophagogastroplasty which was supposed to induce gastric reflux alone or no operation. These results indicated that the duodenoesophageal reflux increased the frequency and changed the histologic type Nepicastat of esophageal cancer in nitrosamine-treated rats suggesting that duodenal refluxate plays a role as a co-carcinogenic factor in the development of esophageal adenocarcinoma. 3 Adenocarcinoma induced by Duodenoesophageal Reflux Only We were the first to statement development of columnar epithelial metaplasia and mucinous adenocarcinoma as Gimap5 well as squamous cell carcinoma using a rodent duodeno-forestomach or duodeno-glandular-forestomach reflux model to put duodenal juice into the esophagus without exogenous carcinogens [2]. Several researchers possess reported many kinds of reflux models (Number 1) and agreed with our idea that carcinogen is definitely unneeded for esophageal carcinogenesis in rodent reflux models [6 7 Number 1. Rodent models of duodenogastroesophageal reflux. (a)-(d) Several kinds of duodenogastroesophageal reflux were founded using rodent models. Duodenum or jejunum is definitely anastomosed with blind end of esophagus or esophagogastric junction. These four … Subsequently we have founded a rodent duodenoesophageal reflux model to produce Become and EAC without administration of any carcinogens and investigated the incidence of esophageal adenocarcinoma in four forms of Nepicastat rodent models shown in Number 2 to elucidate which component is responsible for development of EAC duodenal juice or gastric juice [3]. The duodenoesophageal reflux model (DER) offers regurgitation of duodenal juice only while the gastroesophageal reflux model (GER) offers regurgitation of gastric juice only. The duodenogastroesophageal reflux model (DGER) offers regurgitation of both duodenal and gastric juices but neither reflux happens in the Roux-en Y esophagojejunostomy model (RY). Number 2. (a) Duodenogastroesophageal reflux model (DGER) offers regurgitation of both duodenal and gastric juices; (b) Duodenoesophageal reflux model (DER) offers regurgitation of duodenal juice only; (c) Gastroesophageal reflux model (GER) offers regurgitation of gastric … The incidences of esophageal.