N-nitroso compounds, bacteria, and carcinoembryonic antigen in the gastricstump

Analyses of biochemical and microbiological parameters such as pH, N-nitros o compound (NOC) concentration, carcinoembryonic antigen (CEA) level, and t otal viable counts (TVCs), and identification of microorganisms were carrie d out on 65 fasting gastric juice samples obtained at endoscopy from 45 pat ients previously submitted 60 partial gastrectomy for benign peptic ulcer d isease (23 Billroth I, 22 Billroth II/Reichel-Polya) and 20 normal controls . Biopsy specimens were taken to determine histology, the Helicobacter pylo ri status, and both tissue CEA immunoreactivity and level. Significantly hi gher mean pH values, NOC and CEA concentrations, and TVCs were found in par tial gastrectomies compared with normal controls. In relation to surgical m ethods, higher mean pH values, NOC concentrations, TVCs, and anaerobic bact erial counts were observed in the juice of patients with Billroth II compar ed with Billroth I gastrectomies. Mild CEA immunoreactivity and apical CEA localization were found significantly more often in Billroth II than in Bil lroth I stumps. Intensive CEA immunoreactivity and cytoplasmatic localizati on were found significantly more often in Billroth I than in Billroth II st umps. Independent of the type of surgical reconstruction, higher mean NOC l evels were recorded in patients with more severe histological changes and H , pylori infection. Higher mean CEA levels in gastric juice and tissue were detected in the gastric stumps with more severe histological changes. All these data suggest that high levels of NOCs in the gastric juice could be a cofactor in gastric stump carcinogenesis and determination of CEA level in gastric juice and tissue could be included as a very useful marker in quan tifying this process. (C) 1998 Academic Press.