Direct measurement of gastroesophageal reflux episodes in patients with squamous cell carcinoma by 24-h pH-impedance monitoring

Kaname Uno, Katsunori Iijima, Waku Hatta, Tomoyuki Koike, Yasuhiko Abe, Naoki Asano, Gen Kusaka, Toru Shimosegawa

Research output: Contribution to journalArticlepeer-review

20 Citations (Scopus)


Objectives: Recent studies have consistently reported a significant association between gastric atrophy and esophageal squamous cell carcinomas (ESCCs). However, causative factors responsible for the linkage remain to be clarified. Multichannel intraluminal impedance monitoring in conjunction with a pH sensor (MII-pH) is a reliable technique to evaluate gastroesophageal reflux (GER) episodes, independent of the acidity. We investigated the potential roles of GER in the pathogenesis of ESCC with MII-pH. Methods: From August 2008 to May 2010, 14 consecutive inpatients with superficial ESCCs (ESCC group) and 14 age-and sex-matched inpatients without any esophageal dysplastic lesions (non-ESCC group) were enrolled. Twenty-four hour portable MII-pH monitoring was performed under standard hospitalized conditions. The data of MII-pH were used to identify acid reflux (AR: pH drop below 4.0 during a reflux episode) and non-AR (NAR: pH drop above 4.0 during a reflux episode). Results: The median intragastric pH of the ESCC group was 4.7 (2.3-6.4), implying hypochlorhydria in this patient group. The numbers of total reflux and NAR episodes in the ESCC group were significantly higher than those in the non-ESCC group (56 (43-87) vs. 35.5 (18-47), P=0.016 for total reflux and 46.5 (32-84) vs. 24.5 (8-37), P=0.012 for NAR), whereas the numbers of AR were similar in both groups. In addition, there was significance in the category of percentage time of bolus reflux episodes. Conclusions: Using MII-pH monitoring, we revealed the clinical significance of GER, especially NAR, in ESCCs. NAR may be a key factor in the link between gastric atrophy and ESCCs.

Original languageEnglish
Pages (from-to)1923-1929
Number of pages7
JournalAmerican Journal of Gastroenterology
Issue number11
Publication statusPublished - 2011 Nov

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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