Assessment of the secretin provocation test in the diagnosis of gastrinoma
Assessment of the secretin provocation test in the diagnosis of gastrinoma
复制标题
促胰液素激发试验在胃泌素瘤诊断中的评估
作者：
J. Primrose;J. Ratcliffe;S. Joffe
据推测，静脉注射促胰液素对血浆免疫反应性胃泌素的影响可以提高胃泌素瘤患者的诊断准确性。为了进一步研究这一点，我们在对照患者 (n = 10)、原发性十二指肠溃疡患者 (n = 10)、既往接受过十二指肠溃疡手术的患者 (n = 20)、有症状的复发性消化性溃疡患者 (n = 50) 和 2 名经组织学证实的胃泌素瘤患者中进行了促胰液素激发试验。研究发现，10 名有症状的十二指肠溃疡患者中，有 3 人的促胰液素检测结果呈假阳性；20 名曾接受过十二指肠溃疡手术但现在无症状的患者中，有 2 人的促胰液素检测结果呈假阳性；50 名复发性消化性溃疡患者中，有 15 人的促胰液素检测结果呈假阳性。两名胃泌素瘤患者的促胰液素测试均呈阳性，但没有明显的标准将胃泌素瘤患者的胃泌素反应与原发性或复发性消化性溃疡患者的胃泌素反应区分开来。结论是促胰液素试验对于胃泌素瘤的筛查和诊断可能没有什么价值。
The effect of intravenous secretin on plasma immunoreactive gastrin is presumed to improve diagnostic accuracy in patients with a gastrinoma. To investigate this further, the secretin provocation test was performed in control patients (n = 10), patients with a primary duodenal ulcer (n = 10), patients who had previously had surgery for a duodenal ulcer (n = 20), patients with symptomatic recurrent peptic ulceration (n = 50) and 2 patients with a histologically proved gastrinoma. It was found that the secretin test gave a false positive result in 3 out of 10 symptomatic duodenal ulcer patients, 2 out of 20 patients who had had previous duodenal ulcer surgery and were now asymptomatic and 15 out of 50 patients with recurrent peptic ulceration. Both gastrinoma patients had positive secretin tests but there were no obvious criteria that separated the gastrin response of a gastrinoma patient from those with primary or recurrent peptic ulceration. It is concluded that the secretin test is probably of little value in both the screening and the diagnosis of a gastrinoma.