Skip to main content

Advertisement

Log in

Role of gastric acid secretion in the pathogenesis of Barrett’s esophageal cancer in a Japanese population

  • Clinical Review
  • Published:
Clinical Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

The acidity of the refluxate into the esophagus is an important factor not only for reflux esophagitis, but also for Barrett’s esophagus and the development of Barrett’s esophageal cancer. On the other hand, H. pylori infection is thought to prevent reflux esophagitis and Barrett’s esophagus by causing atrophic gastritis, which in turn decreases gastric acid secretion. Moreover, the preservation of gastric acid secretion may be important for the development of gastroesophageal junction cancer, including Barrett’s esophageal cancer, irrespective of the H. pylori infection status. An increase in gastric acid secretion in Japanese populations has been predicted based on a decreasing rate of H. pylori infection and the westernization of eating habits in Japan; this, in turn, may lead to an increase in the prevalence of Barrett’s esophageal cancer in Japan in the future.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Spechler SJ. Barrett’s esophagus. N Eng J Med. 1986;315:362–71.

    Article  CAS  Google Scholar 

  2. Hassall E. Barrett’s esophagus: congenital or acquired? Am J Gastroenterol. 1993;88:819–24.

    CAS  PubMed  Google Scholar 

  3. Eisen GM, Sandler RS, Murray S, Gottfried M. The relationship between gastroesophageal reflux disease and its complication with Barrett’s esophagus. Am J Gastroenterol. 1997;92:27–31.

    CAS  PubMed  Google Scholar 

  4. Haggitt RC. Barrett’s esophagus, dysplasia, and adenocarcinoma. Hum Pathol. 1994;25:982–93.

    Article  CAS  PubMed  Google Scholar 

  5. Spechler SJ, Zeroogian JM, Antonioli DA, Wang HH, Goyal RK. Prevalence of metaplasia at the gastro-esophageal junction. Lancet. 1994;344:1533–6.

    Article  CAS  PubMed  Google Scholar 

  6. Sampliner RE. Practice guidelines on the diagnosis, surveillance, and therapy of Barrett’s esophagus. The Practice Parameter Committee of the American College of Gastroenterology. Am J Gastroenterol. 1998;93:1028–32.

    Article  CAS  PubMed  Google Scholar 

  7. Takubo K, Aida J, Sawabe M, Arita T, Kato H, Pech O, et al. The normal anatomy around the oesophagogastric junction: a histopathologic view and its correlation with endoscopy. Best Pract Res Clin Gastroenterol. 2008;22:569–83.

    Article  PubMed  Google Scholar 

  8. Hirota WK, Loughney TM, Lazas DJ, Maydonovitch CL, Rholl V, Wong RK. Specialized intestinal metaplasia, dysplasia, and cancer of the esophagus and esophagogastric jynction. Gastoroenterology. 1999;116:277–85.

    Article  CAS  Google Scholar 

  9. Hongo M, Shoji T. Epidemiology of reflux disease and CLE in east Asia. J Gastroenterol. 2003;38(Suppl):25–30.

    PubMed  Google Scholar 

  10. Azuma N, Endo T, Arimura Y, Motoya S, Itoh F, Hinoda Y, et al. Prevalence of Barrett’s esophagus and expression of mucin antigens detected by a panel of monoclonal antibodies in Barrett’s esophagus and esophageal adenocarcinoma in Japan. J Gastroenterol. 2000;35:583–92.

    Article  CAS  PubMed  Google Scholar 

  11. Kawano T, Kouzu T, Kawano T, Ohara S. The prevalence of Barrett’s mucosa in the Japanese (in Japanese with English abstract). Gastroenterol Endosc. 2005;47:951–61.

    Google Scholar 

  12. Devesa SS, Blot WJ, Fraumeni JF. Changing patterns in the incidence of esophageal and gastric carcinoma in the United States. Cancer. 1998;83:2049–53.

    Article  CAS  PubMed  Google Scholar 

  13. Takubo K, Aida J, Sawabe M, Kurosumi M, Arima M, Fujishiro M, et al. Early squamous cell carcinoma of the esophagus: the Japanese viewpoint. Histopathology. 2007;51:733–42.

    Article  CAS  PubMed  Google Scholar 

  14. Bar-Maor JA, He YR, Li D. Barrett’s epithelium with complete stricture of the esophagus: hypothesis of its etiology. J Pediatr Surg. 1995;30:893–5.

    Article  CAS  PubMed  Google Scholar 

  15. Hennessy TP, Edlich RF, Buchin RJ, Tsung MS, Prevost M, Wangensteen OH. Influence on gastroesophageal incompetence on regeneration of esophageal mucosa. Arch Surg. 1968;97:105–7.

    Article  CAS  PubMed  Google Scholar 

  16. Corder AP, Jones RH, Sadler RH, Daniels P, Johnson CD. Heart-burn, oesophagitis and Barrett’s esophagus in self-medicating patients in general practice. Br J Clin Pract. 1996;50:245–8.

    CAS  PubMed  Google Scholar 

  17. Winters C Jr, Spurling TJ, Chobanian SJ, Curtis DJ, Esposito RL, Hacker JF 3rd, et al. Barrett’s esophagus. A prevalent, occult complication of gastroesophageal reflux disease. Gastroenterology. 1987;92:118–24.

    Article  PubMed  Google Scholar 

  18. Csendes A, Smok G, Burdiles P, Quesada F, Huertas C, Rojas J, et al. Prevalence of Barrett’s esophagus by endoscopy and histologic studies : a prospective evaluation of 306 control subjects and 376 patients with symptoms of gastroesophageal reflux. Dis Esophagus. 2000;13:5–11.

    Article  CAS  PubMed  Google Scholar 

  19. Lieberman DA, Oehlke M, Helfand M. Risk factors for Barrett’s esophagus in community-based practice. GORGE consortium. Gastroenterology Outcomes Research Group in Endoscopy. Am J Gastroenterol. 1997;92:1293–7.

    CAS  PubMed  Google Scholar 

  20. Romero Y, Cameron AJ, Schaid DJ, McDonnell SK, Burgart LJ, Hardtke CL, et al. Barrett’s esophagus: prevalence in symptomatic relatives. Am J Gastroenterol. 2002;97:1127–32.

    Article  PubMed  Google Scholar 

  21. Fass R, Hell RW, Garewal HS, Martnez P, Pulliam G, Wendel C, et al. Correlation of oesophageal acid exposure with Barrett’s oesophagus length. Gut. 2001;48:310–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Vaezi MF, Richter JE. Role of acid and duodenogastroesophageal reflux in gastroesophageal reflux disease. Gastroenterology. 1996;111:1192–9.

    Article  CAS  PubMed  Google Scholar 

  23. Nehra D, Howell P, Williams CP, Pye JK, Beynon J. Toxic bile acids in gastro-esophageal reflux disease: influence of gastric acidity. Gut. 1999;44:598–602.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Avidan B, Sonnenberg A, Schnell TG, Chejfec G, Metz A, Sontag SJ. Hiatal hernia size, Barrett’s length, and severity of acid reflux are all risk factors for esophageal adenocarcinoma. Am J Gastroenterol. 2002;97:930–1936.

    Google Scholar 

  25. Iijima K, Ohara S, Sekine H, Koike T, Kubota Y, Kato K, et al. A new endoscopic method of gastric acid secretory testing. Am J Gastroenterol. 1998;93:2113–8.

    Article  CAS  PubMed  Google Scholar 

  26. Iijima K, Ohara S, Sekine H, Koike T, Kato K, Asaki S, et al. Changes in gastric acid secretion assayed by endoscopic gastrin test before and after Helicobacter pylori eradication. Gut. 2000;46:20–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Iijima K, Sekine H, Koike T, Imatani A, Ohara S, Shimosegawa T. Long-term effect of Helicobacter pylori eradication on the reversibility of acid secretion in profound hypochlorhydiria. Aliment Pharmacol Ther. 2004;19:1181–8.

    Article  CAS  PubMed  Google Scholar 

  28. Iijima K, Ohara S, Koike T, Sekine H, Shimosegawa T. Gastric acid secretion of normal Japanese subjects in relation to Helicobacter pylori infection, aging, and gender. Scand J Gastroenterol. 2004;8:709–16.

    Article  Google Scholar 

  29. Kato S, Ozawa K, Koike T, Sekine H, Ohara S, Minoura T, et al. Effect of Helicobacter pylori infection on gastric acid secretion and meal-stimulated serum gastrin in children. Helicobacter. 2004;9:100–5.

    Article  PubMed  Google Scholar 

  30. Koike T, Ohara S, Sekine H, Iijima K, Kato K, Shimosegawa T, et al. Helicobacter pylori infection inhibits reflux esophagitis by inducing atrophic gastritis. Am J Gastroenterol. 1999;94:3468–72.

    Article  CAS  PubMed  Google Scholar 

  31. Koike T, Ohara S, Sekine H, iijima K, Abe Y, Kato K, et al. Helicobacter pylori infection prevents erosive reflux oesophagitis by decreasing gastric acid secretion. Gut. 2001;49:330–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Corley DA, Kubo A, Levin TR, eBlock G, Habel L, Zhao W, et al. Helicobacter pylori infection and the risk of Barrett’s oesophagus: a community-based study. Gut. 2008;57:727–33.

    Article  CAS  PubMed  Google Scholar 

  33. Weston AP, Badr AS, Topalovski M, Cherian R, Dixon A, Hassanein RS. Prospective evaluation of the prevalence of gastric Helicobacter pylori infection in patients with GERD, Barrett’s esophagus, Barrett’s dysplasia, and Barrett’s adenocarcinoma. Am J Gastroenterol. 2000;95:387–94.

    Article  CAS  PubMed  Google Scholar 

  34. Quddus MR, Henley JD, Sulaiman RA, Paumbo TC, Gnepp DR. Helicobacter pylori infection and adenocarcinoma arising in Barrett’s esophagus. Hum Pathol. 1997;28:1007–9.

    Article  CAS  PubMed  Google Scholar 

  35. Henihan RD, Stuart RC, Nolan N, Gorey TF, Hennessy TP, O’Morain CA. Barrett’s esophagus and the presence of Helicobacter pylori. Am J Gastroenterol. 1998;93:542–6.

    Article  CAS  PubMed  Google Scholar 

  36. Abe Y, Ohara S, Koike T, Sekine H, Iijima K, Kawamura M, et al. The prevalence of Helicobacter pylori infection and the status of gastric acid secretion in patients with Barrett’s esophagus in Japan. Am J Gastroenterol. 2004;99:1213–21.

    Article  PubMed  Google Scholar 

  37. Inomata Y, Koike T, Ohara S, Abe Y, Sekine H, Iijima K, et al. Presevation of gastric acid secretion may be important for the development of gastroesophageal junction adenocarcinoma in Japanese people, irrespective of the H. pylori infection status. Am J Gastroenterol. 2006;101:926–33.

    Article  PubMed  Google Scholar 

  38. Koike T, Ohara S, Inomata Y, Abe Y, Iijima K, Shimosegawa T. The prevalence of Helicobacter pylori infection and the status of gastric acid secretion in patients with gastroesophageal junction adenocarcinoma in Japan. Inflammopharmacology. 2007;15:61–4.

    Article  CAS  PubMed  Google Scholar 

  39. Kuipers EJ, Perez-Perez GI, Meuwissenn SG, Blaser MJ. Helicobacter pylori and atrophic gastritis: importance of the cagA status. J Natl Cancer Inst. 1995;87:1777–80.

    Article  CAS  PubMed  Google Scholar 

  40. Yasunaga Y, Shinomura Y, Kanayama S, Higashimoto Y, Yabu M, Miyazaki Y, et al. Mucosal interleukin 1 beta production and acid secretion in enlarged fold gastritis. Aliment Pharmacol Ther. 1997;11:801–9.

    Article  CAS  PubMed  Google Scholar 

  41. El-Omar EM. The importance of interleukin 1-beta in Helicobacter pylori associated disease. Gut. 2001;48:743–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Ohyauchi M, Imatani A, Yonechi M, Asano N, Miura A, Iijima K, et al. The polymorphism interleukin-8 251 A/T influences the susceptibility of Helicobacter pylori-related gastric diseases in the Japanese population. Gut. 2005;54:330–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Azuma T, Konishi J, Tanaka Y, Hirai M, Ito S, Kato T, et al. Contribution of HLA-DQA gene to hosts response against H. pylori. Lancet. 1994;343:542–3.

    Article  CAS  PubMed  Google Scholar 

  44. Parsonnet J, Friedman GD, Vandersteen DP, Chang Y, Voqelman JH, Orenterich N, et al. Helicobacter pylori infection and the risk of gastric carcinoma. N Engl J Med. 1991;325:1127–31.

    Article  CAS  PubMed  Google Scholar 

  45. Nomura A, Stemmermann GN, Chyou PH, Kato I, Perez-Perez GI, Blaser MJ. Helicobacter pylori infection and gastric carcinoma among Japanese Americans in Hawaii. N Engl J Med. 1991;325:1132–6.

    Article  CAS  PubMed  Google Scholar 

  46. Haung JQ, Sridhar S, Chen Y, Hunt RH. Meta-analysis of the relationship between Helicobacter pylori seropositivity and gastric cancer. Gastroenterology. 1998;114:1169–79.

    Article  Google Scholar 

  47. Uemura N, Okamoto S, Yamamoto S, Matsumura N, Yamaguchi S, Yamakido M, et al. Helicobacter pylori infection and the development of gastric cancer. N Engl J Med. 2001;345:784–9.

    Article  CAS  PubMed  Google Scholar 

  48. Svendsen JH, Svendsen CD, Christiansen PM. Gastric cancer risk in achlorhydric patients. A long-term follow-up study. Scand J Gastroenterol. 1986;21:16–20.

    Article  CAS  PubMed  Google Scholar 

  49. Asaka M, Kimura T, Kato M, Kudo M, Miki K, Ogoshi K, et al. Possible role of Helicobacter pylori infection in early gastric cancer development. Cancer. 1994;73:2691–4.

    Article  CAS  PubMed  Google Scholar 

  50. Iijima K, Henry E, Moriya A, Wirz A, Kelman AW, McColl KE. Dietary nitrate generates potentially mutagenic concentrations of nitric oxide at the gastroesophageal junction. Gastroenterology. 2002;122:1248–57.

    Article  CAS  PubMed  Google Scholar 

  51. Asanuma K, Iijima K, Sugata H, Ohara S, Shimosegawa T, Yoshimura T. Diffusion of cytotoxic concentrations of nitric oxide generated luminally at the gastro-oesophageal junction of rats. Gut. 2005;54:1072–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. Suzuki H, Iijima K, Scobie G, Fyfe V, McColl KE. Nitrate and nitrosative chemistry within Barrett’s oesophagus during acid reflux. Gut. 2005;54:1527–35.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Ara N, Iijima K, Asanuma K, Yoshitaka J, Ohara S, Shimosegawa T, et al. Disruption of gastric barrier function by luminal nitrosative stress: a potential chemical insult to the human gastro-oesophageal junction. Gut. 2008;57:306–13.

    Article  CAS  PubMed  Google Scholar 

  54. Manabe N, Yoshihara M, Sasaki A, Tanaka S, Haruma K, Chayama K. Clinical characteristics and natural history of patients with low-grade reflux esophagitis. J Gastroenterol Hepatol. 2002;17:949–54.

    Article  PubMed  Google Scholar 

  55. Iwakiri K, Sugiura T, Hayashi Y, Kotoyori M, Kawakami A, Makino H, et al. Esophageal motility in Japanese patients with Barrett’s esophagus. J Gastroenterol. 2003;38:1036–41.

    Article  PubMed  Google Scholar 

  56. Zentilin P, Reglioni S, Savarino V. Pathophysiological characterisitics of long and short segment Barrett’s esophagus. Scand J Gastroenterol. 2003;239(Suppl 38):40–3.

    Google Scholar 

  57. Asaka M, Kimura T, Kudo M, Takeda H, Mitani S, Miyazaki T, et al. Relationship of Helicobacter pylori to serum pepsinogen in an asymptomatic Japanese population. Gastroenterology. 1992;102:760–6.

    Article  CAS  PubMed  Google Scholar 

  58. Fujisawa T, Kumagai T, Akamatsu T, Kiyosawa K, Matsunaga Y. Changes in seroepidemiological pattern of Helicobacter pylori and hepatitis A virus over the last 20 years in Japan. Am J Gastroenterol. 1999;94:2094–9.

    Article  CAS  PubMed  Google Scholar 

  59. Kinoshita Y, Kawanami C, Kishi K, Nakata H, Seino Y, Chiba T. Helicobacter pylori independent chronological change in gastric acid secretion in the Japanese. Gut. 1997;41:452–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tomoyuki Koike.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Koike, T., Ohara, S. & Shimosegawa, T. Role of gastric acid secretion in the pathogenesis of Barrett’s esophageal cancer in a Japanese population. Clin J Gastroenterol 2, 143–148 (2009). https://doi.org/10.1007/s12328-009-0082-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12328-009-0082-z

Keywords

Navigation