Abstract | STUDY OBJECTIVE: DESIGN: Prospective trial in consecutive patients. SETTING: Referrals to a clinical research center. PATIENTS: INTERVENTION: MEASUREMENTS AND MAIN RESULTS: There was no significant difference in the responses of patients with different extents or locations of the tumor, presence or absence of multiple endocrine neoplasia, type-I, or with fasting gastrin less than or greater than 1000 pg/mL. In patients with fasting gastrin of less than 1000 pg/mL, the sensitivity of the secretin test using the criterion of an increase in gastrin of at least 110 pg/mL was 93% (CI, 76% to 99%) and for an increase of 200 pg/mL it was 85% (CI, 66% to 96%), (P greater than 0.05). With the calcium infusion test, the sensitivity using the criterion of an increase of 395 pg/mL was 43%, (CI, 23% to 66%) and for an increase of 50% was 74% (CI, 52% to 90%), (P less than 0.01). The calcium infusion test was positive in 33% of patients with a negative secretin test. With the secretin test, 75% of patients had a positive response by 5 minutes, 95% by 10 minutes, 100% by 15 minutes, and 6% only at 2 minutes. With calcium infusion, patients had positive responses at 120 to 180 minutes. CONCLUSIONS: The secretin test is preferred over the calcium test because of its greater sensitivity and simplicity. The recommended criteria are a 200 pg/mL increase for the secretin test and a 395 pg/mL increase for the calcium test. The calcium test should be reserved for patients having a negative secretin test, gastric acid hypersecretion, and a strong clinical suspicion of the Zollinger-Ellison syndrome.
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Authors | H Frucht, J M Howard, J I Slaff, S A Wank, D M McCarthy, P N Maton, R Vinayek, J D Gardner, R T Jensen |
Journal | Annals of internal medicine
(Ann Intern Med)
Vol. 111
Issue 9
Pg. 713-22
(Nov 01 1989)
ISSN: 0003-4819 [Print] United States |
PMID | 2572194
(Publication Type: Journal Article)
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Chemical References |
- Gastrins
- Secretin
- Calcium
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Topics |
- Adolescent
- Adult
- Aged
- Calcium
- Chi-Square Distribution
- Confidence Intervals
- Fasting
(blood)
- Female
- Gastrins
(blood)
- Humans
- Male
- Middle Aged
- Multiple Endocrine Neoplasia
(blood)
- Prospective Studies
- Secretin
- Sensitivity and Specificity
- Time Factors
- Zollinger-Ellison Syndrome
(blood, diagnosis)
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