Kothary P C, Fabri P J, Gower W, O'Dorisio T M, Ellis J, Vinik A I
J Clin Endocrinol Metab. 1986 May;62(5):970-4. doi: 10.1210/jcem-62-5-970.
Forty-six patients with the gastrinoma syndrome were divided into 2 categories: 1) benign sporadic gastrinoma (n = 30), and 2) gastrinoma with metastases to liver (n = 16). Thirteen of the 46 patients had multiple endocrine neoplasia type I syndrome. Serum gastrin levels in patients fasted overnight were determined by RIA using antisera directed toward the NH2- and COOH-terminals of heptadecapeptide gastrin (G17) and the NH2-terminus of the triacontatetrapeptide (G34). These results were compared with findings in 50 normal subjects. In the normal subjects, the mean COOH-terminal gastrin-17 level was higher [65 +/- 8 (+/- SEM) pg/ml] than the NH2-terminal gastrin-17 level (11 +/- 0.2 pg/ml) and lower than the NH2-terminal gastrin-34 level (134 +/- 20 pg/ml). The levels of NH2-terminal gastrin-17 were higher in patients with metastatic disease than in those with benign gastrinoma, whereas the COOH-terminal gastrin-17 and the NH2-terminal gastrin-34 levels were similarly high in both groups. The mean ratio of NH2-terminal gastrin-17 to COOH-terminal gastrin-17 was less than 1 in normal subjects (0.22 +/- 0.02) and benign gastrinoma patients (0.2 +/- 0.04), and it was 2.2 +/- 0.41 in the patients with metastatic gastrinoma. An NH2 to COOH gastrin-17 ratio greater than 1 was found in 13 of 16 patients with metastatic gastrinoma, but in none of the patients with benign gastrinoma or normal subjects. Similar results were found in multiple endocrine neoplasia type I patients with benign and metastatic disease. A high NH2 to COOH gastrin-17 ratio is suggestive of metastatic gastrinoma. In 4 patients with metastatic gastrinoma, the NH2 to COOH gastrin-17 ratio fell in parallel with the response to chemotherapy.
46例胃泌素瘤综合征患者被分为2类：1）良性散发性胃泌素瘤（n = 30），以及2）伴有肝转移的胃泌素瘤（n = 16）。46例患者中有13例患有I型多发性内分泌肿瘤综合征。使用针对十七肽胃泌素（G17）的NH2端和COOH端以及三十四肽（G34）的NH2端的抗血清，通过放射免疫分析法测定过夜禁食患者的血清胃泌素水平。将这些结果与50名正常受试者的结果进行比较。在正常受试者中，平均COOH端胃泌素-17水平[65±8（±标准误）pg/ml]高于NH2端胃泌素-17水平（11±0.2 pg/ml），且低于NH2端胃泌素-34水平（134±20 pg/ml）。转移性疾病患者的NH2端胃泌素-17水平高于良性胃泌素瘤患者，而两组中COOH端胃泌素-17和NH2端胃泌素-34水平同样高。正常受试者（0.22±0.02）和良性胃泌素瘤患者（0.2±0.04）中，NH2端胃泌素-17与COOH端胃泌素-17的平均比值小于1，而转移性胃泌素瘤患者中该比值为2.2±0.41。16例转移性胃泌素瘤患者中有13例的NH2与COOH胃泌素-17比值大于1，但良性胃泌素瘤患者或正常受试者中均未发现。在患有良性和转移性疾病的I型多发性内分泌肿瘤患者中也发现了类似结果。高NH2与COOH胃泌素-17比值提示转移性胃泌素瘤。在4例转移性胃泌素瘤患者中，NH2与COOH胃泌素-17比值随化疗反应而平行下降。
