N-nitroso compounds and Helicobacter pylori in the gastric remnant

Aims and background: The aims of this study were to investigate the role of N-nitroso compounds (NOC) and Helicobacter pylori (H. pylori) in gastric s tump carcinogenesis. Methods and study design: Analyses of biochemical parameters such as pH and NOC concentration were carried out on 65 fasting gastric juice samples obt ained at endoscopy from 45 patients previously submitted to partial gastrec tomy for benign peptic ulcer disease (23 Billroth 1, 22 Billroth II/Reichel -Polya) and 20 normal controls. Biopsy specimens were taken to determine hi stology and H. pylori status. Results: Significantly higher mean pH values and NOC concentrations were fo und in partial gastrectomies compared to normal controls. In relation to su rgical methods, higher mean pH values and NOC concentrations were observed in the gastric juice of patients with Billroth II compared to Billroth I ga strectomies. Independently of the type of surgical reconstruction, higher m ean NOC levels were recorded in patients with more severe histological chan ges and H. pylori infection. Conclusions: All these data suggest that high levels of NOC in gastric juic e and H. pylori infection could be cofactors in gastric stump carcinogenesi s.