Lamers C B, Diemel C M
J Clin Endocrinol Metab. 1982 Oct;55(4):774-8. doi: 10.1210/jcem-55-4-774.
The present study was undertaken to determine the value of measurement of basal and postatropine serum pancreatic polypeptide (PP) levels for the diagnosis of endocrine pancreatic tumors in affected members of families with multiple endocrine neoplasia type I (MEN I). Basal serum PP levels were elevated in 3 of 19 affected members of 6 families with MEN I. The 3 patients with elevated serum PP (115--157 pmol/liter) had evidence of gastrin-producing tumors. In 5 other patients with evidence of gastrinoma from MEN I families serum PP levels were normal. All 11 family members affected with MEN I without pancreatic tumors had normal serum PP concentrations. Intravenous administration of 1 mg atropine to all 19 affected members of MEN I families and to 8 normal control subjects inhibited serum PP in all of them. Serum PP in the 3 MEN I patients with elevated PP decreased markedly in response to atropine but remained higher than the postatropine serum PP concentrations in the other subjects. It is concluded that an elevated serum PP is a relatively insensitive marker for endocrine pancreatic tumors in MEN I. The observation that atropine inhibits serum PP levels in MEN I patients with endocrine pancreatic tumors throws doubt on the clinical usefulness of an atropine suppression test for PP in the diagnosis of pancreatic endocrine tumors.
本研究旨在确定测定基础和阿托品激发后血清胰多肽（PP）水平对诊断Ⅰ型多发性内分泌腺瘤病（MEN I）家族中受影响成员的胰腺内分泌肿瘤的价值。在6个MEN I家族的19名受影响成员中，有3人的基础血清PP水平升高。血清PP升高的3例患者（115 - 157 pmol/升）有胃泌素瘤的证据。在另外5例来自MEN I家族且有胃泌素瘤证据的患者中，血清PP水平正常。所有11名受MEN I影响但无胰腺肿瘤的家族成员血清PP浓度均正常。对所有19名MEN I家族受影响成员及8名正常对照受试者静脉注射1 mg阿托品后，所有人的血清PP均受到抑制。3例PP升高的MEN I患者的血清PP对阿托品反应明显降低，但仍高于其他受试者的阿托品激发后血清PP浓度。结论是，血清PP升高对MEN I中的胰腺内分泌肿瘤来说是一个相对不敏感的标志物。阿托品能抑制患有胰腺内分泌肿瘤的MEN I患者的血清PP水平这一观察结果，让人对阿托品抑制试验在诊断胰腺内分泌肿瘤时检测PP的临床实用性产生怀疑。
