Diagnostic efficacy of the secretin stimulation test for the Zollinger-Ellison syndrome: an intra-individual comparison using different dosages in patients and controls.

Abstract

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 microg/kg and 0.78 microg/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 microg/kg compared to 0.26 microg/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 microg/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 microg/kg secretin stimulation test has the best diagnostic efficacy for the ZES. and IAP.

• Authors: Patricia Kuiper, Izäk Biemond, Ad A Masclee, Jan B Jansen, Hein W Verspaget, Cornelis B Lamers
• Journal: Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] (Pancreatology) Vol. 10 Issue 1 Pg. 14-8 ( 2010) ISSN: 1424-3911 [Electronic] Switzerland
• PMID: 20299818 (Publication Type: Evaluation Study, Journal Article, Validation Study)

Chemical References

• Gastrins
• Secretin

Topics

• Fasting
• Female
• Gastrins (blood)
• Humans
• Male
• Middle Aged
• Secretin
• Sensitivity and Specificity
• Zollinger-Ellison Syndrome (diagnosis)