Possible association of active gastritis, featuring accelerated cell turnover and p53 overexpression, with cancer development at anastomoses after gastrojejunostomy - Comparison with gastroduodenostomy

To cast light on tumorigenesis ir 2 the remnant stomach after distal gastre ctomy for peptic ulcer or gastric cancel; 45 cases in gastroduodenostomy (B illroth I, 17 cases) and gastrojejunostomy (Billroth II, 28 cases) groups w ere compared for (7 series of parameters. Cancers in Billroth II were signi ficantly more predominant in the anastomosis nr en and more frequently asso ciated with Epstein-Barr virus infection. Active gastritis, accelerated epi thelial cell turnover las assessed by measurements of apoptosis and cell pr oliferation?), DNA damage, and foveolar cell hyperplasia were all greater i n anastomotic areas after Billroth II than in proximal areas after Billroth II or either area after Billroth I. K-ras mutations were rare, Dot Epstein -Barr virus infection in cancers was seen frequently in anastomosis cases. In conclusion, active gastritis, possibly induced by enterogastric reflux, is linked to tumorigenesis in anastomosis sites ill Billroth II cases.