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Prospective controlled trial of a standardized meal stimulation test in the detection of pancreaticoduodenal endocrine tumours in patients with multiple endocrine neoplasia type 1
- Source :
- The British journal of surgery. 88(10)
- Publication Year :
- 2001
-
Abstract
- Background Use of a standardized meal stimulation test has been recommended for the early diagnosis of pancreaticoduodenal endocrine tumours (PETs) in patients with multiple endocrine neoplasia type 1 (MEN 1). The diagnostic value of this test was re-evaluated. Methods In a prospective, controlled trial 58 standardized meal stimulation tests (563 kcal) were performed in 12 patients with MEN 1 and histologically, biochemically and/or radiologically confirmed PETs (group 1), 11 carriers of an MEN 1 mutation with no evidence of PETs (group 2) and in 27 healthy controls (group 3). Serum pancreatic polypeptide (PP) and gastrin concentrations were measured before and during the test meal. Results Patients in group 1 had significantly higher mean basal serum PP and gastrin concentrations than patients in group 2 and controls (P < 0·05). In all three groups an increase in serum PP was observed after meal stimulation, but there was no significant difference between the groups. No increase in gastrin level was found in any of the groups after meal stimulation. Conclusion The standardized meal stimulation test does not reliably indicate the presence of PETs in patients with MEN 1, whereas raised basal serum PP and gastrin levels do. The expensive and time-consuming meal test can be excluded from MEN 1 screening programmes.
- Subjects :
- Adult
Male
medicine.medical_specialty
Pancreatic disease
Pancreatic Polypeptide
Gastroenterology
Duodenal Neoplasms
Internal medicine
Gastrins
medicine
Multiple Endocrine Neoplasia Type 1
Pancreatic polypeptide
Endocrine system
Humans
Prospective Studies
Multiple endocrine neoplasia
Gastrin
Aged
Meal
business.industry
digestive, oral, and skin physiology
Middle Aged
medicine.disease
Pancreatic Neoplasms
medicine.anatomical_structure
Endocrinology
Mutation
Duodenum
Surgery
Female
business
Pancreas
Subjects
Details
- ISSN :
- 00071323
- Volume :
- 88
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- The British journal of surgery
- Accession number :
- edsair.doi.dedup.....721c82ba3ec9bc77711eb2378053752d