Division of Biological Regulation and Oncology, Department of Surgery, Tohoku University School of Medicine, 1-1 Seriyo-machi, Aoba-ku, Sendai, 980-8574, Japan,
Surg Today. 2013 Nov;43(11):1281-5. doi: 10.1007/s00595-012-0334-2. Epub 2012 Sep 16.
The glucagon provocative test is useful for the diagnosis of gastrinoma. The aim of this study was to determine the criteria for the glucagon provocative test.
This study reviewed 8 patients that underwent the glucagon provocative test preoperatively and in whom the diagnosis was confirmed as gastrinoma histologically. The glucagon provocative test was performed by administering glucagon (20 μg/kg) intravenously, followed by 20 μg/kg h for the next 30 min, and plasma gastrin levels were measured 3 and 1 min before and 3, 5, 7, 10, 15, 20, and 30 min after the administration of glucagon. This study evaluated the peak value of plasma gastrin and the time required to reach the peak.
Two of the 8 patients had multiple endocrine neoplasm type 1. The basal plasma gastrin levels ranged from 524 to 10,300 pg/ml. The time required to reach the peak was 3-10 min for all patients. The increase in the peak from the basal value was 235-8,920 pg/ml, and the percentage of increase was 38-337 %.
These results suggest that a diagnosis of gastrinoma should thus be made when plasma gastrin levels peak within 10 min after glucagon administration, with an increase of greater than 200 pg/ml and greater than 35 % of the basal value.
胰高血糖素激发试验对胃泌素瘤的诊断具有重要价值。本研究旨在确定胰高血糖素激发试验的标准。
本研究回顾性分析了 8 例术前接受胰高血糖素激发试验且病理诊断为胃泌素瘤的患者。通过静脉注射胰高血糖素（20μg/kg），随后在接下来的 30 分钟内以 20μg/kg/h 的速度给药，并在给药前 3 分钟和 1 分钟以及给药后 3、5、7、10、15、20 和 30 分钟测量血浆胃泌素水平。本研究评估了血浆胃泌素的峰值和达到峰值所需的时间。
8 例患者中有 2 例患有多发性内分泌肿瘤 1 型。基础血浆胃泌素水平为 524-10300 pg/ml。所有患者达到峰值的时间为 3-10 分钟。从基础值到峰值的增加为 235-8920 pg/ml，增加幅度为 38%-337%。
因此，当胰高血糖素给药后 10 分钟内血浆胃泌素水平达到峰值，增加幅度大于 200 pg/ml，且大于基础值的 35%时，应诊断为胃泌素瘤。
