Ouchi K, Kameyama J, Hoshikawa T, Matsumoto O, Ishiyama S, Toyono M, Tsukamoto M
Department of Surgery, Yamagata University School of Medicine, Japan.
Nihon Geka Gakkai Zasshi. 1990 Feb;91(2):262-5.
It is well known that primary hyperparathyroidism is often associated with peptic ulcer. The purpose of this study is to confirm the relationship between the gastrin-levels before and after parathyroidectomy in fourteen patients with primary hyperparathyroidism, and to determine the localization of gastrin in the surgically resected parathyroid tumor. The results obtained were as follows: 1) Three patients had peptic ulcer (gastric ulcer and duodenal ulcer), the incidence being 21%. 2) The basal serum gastrin levels were 123.0% +/- 68.1 pg/ml before operation and decreased to 90.2 +/- 44.5 pg/ml after operation. In the 3 patients with slightly elevated gastrin levels, the mean level before operation was 209.1 +/- 61.2 pg/ml. The gastrin level decreased to 116.4 +/- 62.0 pg/ml after operation. 3) Gastrin immunoreactivity was detected in 10 out of 14 tumors and its localization was at the periphery of tumor cells. From these results, we conclude that extragastric gastrin secretion from parathyroid tumors may be one of the cause of peptic ulcer in patients with primary hyperparathyroidism.
众所周知，原发性甲状旁腺功能亢进常与消化性溃疡相关。本研究的目的是证实14例原发性甲状旁腺功能亢进患者甲状旁腺切除术前、后胃泌素水平之间的关系，并确定胃泌素在手术切除的甲状旁腺肿瘤中的定位。所得结果如下：1）3例患者患有消化性溃疡（胃溃疡和十二指肠溃疡），发病率为21%。2）术前基础血清胃泌素水平为123.0%±68.1 pg/ml，术后降至90.2±44.5 pg/ml。在3例胃泌素水平轻度升高的患者中，术前平均水平为209.1±61.2 pg/ml。术后胃泌素水平降至116.4±62.0 pg/ml。3）14个肿瘤中有10个检测到胃泌素免疫反应性，其定位在肿瘤细胞周边。从这些结果中，我们得出结论，甲状旁腺肿瘤的胃外胃泌素分泌可能是原发性甲状旁腺功能亢进患者消化性溃疡的原因之一。
