Diagnostic Efficacy of the Secretin Stimulation Test for the Zollinger-Ellison Syndrome: An Intra-Individual Comparison Using Different Dosages in Patients and Controls

作者：Kuiper Patricia^*; Biemond Izak; Masclee Ad A; Jansen Jan B; Verspaget Hein W; Lamers Cornelis B

来源：Pancreatology, 2010, 10(1): 14-18.

DOI：10.1159/000265936

• Gastrinoma
• Secretin
• Gastrin
• Hypergastrinemia

Background/Aims: The secretin stimulation test is the principal diagnostic tool to identify Zollinger-Ellison syndrome (ZES). We investigated, by intra-individual comparison, which dose of secretin results in the highest diagnostic efficacy to identify the ZES. Methods: Fifty-seven paired secretin stimulation tests, using both 0.26 mu g/kg and 0.78 mu g/kg secretin, performed in 13 ZES patients and 12 controls, were analyzed and the findings confirmed in a validation cohort. Results: A gastrin increase of > 100 ng/l was found to be the most sensitive and specific criterion for a positive test. Higher gastrin increases after 0.78 mu g/kg compared to 0.26 mu g/kg secretin contributed to a slightly more sensitive (82.9 vs. 80.5%) but less specific (68.8 vs. 81.3%) test. A validation cohort, with 98 tests using 0.26 mu g/kg secretin in 21 ZES patients and 39 controls, provided similar results. In ZES patients with normal fasting serum gastrin levels ( < 100 ng/l), there was no diagnostic benefit from the use of a higher secretin dose. Conclusions: The 0.26 mu g/kg secretin stimulation test has the best diagnostic efficacy for the ZES.

• 出版日期2010