Ornithine decarboxylase (ODC) activity and polyamine levels in mucosal specimens obtained by endoscopic biopsy from the stomal portion and greater curvature of the gastric remnant mucosa taken from 181 patients were determined and compared with the histopathological findings. The results obtained can be summarized as follows. (a) The ODC activity was significantly higher in the stomal portion [455 +/- 340 (mean +/- SD)] of the gastric remnant than in the greater curvature (148 +/- 107). The ODC activity of the stomal portion was significantly higher following a Billroth's II method (599 +/- 417) than following any other operative method that consists of a Billroth's I method (327 +/- 172) and a Roux-en Y (341 +/- 191). (b) The levels of total polyamine, putrescine, spermidine, and spermine were also significantly higher in the stomal portion of the gastric remnant than in the greater curvature. There were no significant differences in the stomal tissue level of any of these substances among operative procedures used. (c) Histopathological changes consisting of glandular dilatation and an irregular glandular structure were detected more frequently in the stomal mucosal specimens, especially following a Billroth's II method. In summary, the present findings suggest that the measurement of ODC activity may thus be considered as one method of estimating the risk of carcinogenesis.

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