N-NITROSO COMPOUNDS IN THE GASTRIC-JUICE OF NORMAL CONTROLS, PATIENTSWITH PARTIAL GASTRECTOMIES, AND GASTRIC-CANCER PATIENTS

Background: It has been suggested that the variation of biochemical an d microbiological parameters in the gastric juice may play a role in t he development of gastric cancer. In the present study we concurrently assessed the presence of N-Nitroso compounds (NOC) and their precurso rs, bacteria and carcinoembryonic antigen (CEA) in the gastric juice o f normal controls, patients with gastric resection, and advanced gastr ic cancer. Methods: Detailed analyses of biochemical and microbiologic al parameters such as pH, nitrite (NO2) concentration, N-nitroso compo unds (NOC) concentration, carcino-embryonic antigen (CEA) level, total viable counts (TVC), nitrate-reductase positive bacterial counts (NRP BC), and identification of micro-organisms were carried out. Results: Significantly higher mean pH values, NO2, NOC and CEA concentrations, TVC, and NRPBC were found in partial gastrectomies compared with norma l controls, and all these intragastric parameters were significantly h igher in patients with gastric cancer than in those with partial gastr ectomies. As far as surgical methods an concerned, higher mean pH valu es, NO2 and NOC concentrations, TVC, NRPBC, and anaerobic bacterial co unts were observed in the juice of patients with Billroth II compared with Billroth I gastrectomies. Apart from the type of surgical reconst ruction, higher mean NOC levels were recorded in patients with more se vere histological changes and H. pylori infection. Conclusions: All th ese data suggest that the presence of high levels of NOC in the gastri c juice of gastroresected patients can be considered a risk factor of gastric stump cancer. (C) 1996 Wiley-Liss, Inc.