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. 2018 Sep 6;11:309–316. doi: 10.2147/CEG.S141642

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© 2018 Torres-Aguilera and Remes Troche. This work is published and licensed by Dove Medical Press Limited

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Model representing the pathophysiologic mechanisms related to the development of ESCC in patients with achalasia.

Notes: The model illustrates food stasis in which bacterial overgrowth causes fermentation and produces lactic acid. Interaction with co-carcinogens, such as nitrosamines, and other genetic and environmental factors produces chronic inflammation, which, after several years, induces dysplasia and then cancer.

Abbreviations: ESCC, esophageal squamous cell carcinoma; HPV, human papillomavirus; EBV, Epstein–Barr virus.