Bradley E L, Galambos J T
Surg Gynecol Obstet. 1976 Nov;143(5):784-8.
In contrast to normal physiologic feedback suppression of serum gastrin by secretin, a paradoxic rise in the serum gastrin level has been observed in patients with gastrinoma after the administration of exogenous secretin. Exploitation of this phenomenon in the differential diagnosis of gastrinoma has been restricted by limited individual experience. Serial serum specimens for gastrin radioimmunoassay were collected from 13 patients with histologically proved gastrinoma both before and after the administration of Boot's secretin, 3 units per kilogram. Thirty-nine others with histologically proved gastrinoma who had been studied with exogenous secretin were identified in the literature. Both the peak gastrin and the integrated gastrin responses were increased after secretin administration in each of the patients in this combined series, although the magnitude of the increase was small in four patients. The absence of physiologic suppression by secretin implies neoplastic autonomy of gastrin releasing sites. While an augmented gastrin response to secretin is commonly seen in patients with gastrinoma, from a physiologic standpoint, a lack of suppression constitutes a positive secretin suppression test. Accumulated experience is consistent and suggests that this test is an important adjunt in the differential diagnosis of hypergastrinemia.
与促胰液素对血清胃泌素的正常生理反馈抑制相反，胃泌素瘤患者在给予外源性促胰液素后，血清胃泌素水平出现反常升高。由于个人经验有限，这种现象在胃泌素瘤鉴别诊断中的应用受到限制。对13例经组织学证实为胃泌素瘤的患者，在给予每千克体重3单位的Boot's促胰液素前后，采集系列血清标本进行胃泌素放射免疫测定。在文献中还确定了另外39例经组织学证实为胃泌素瘤且已接受外源性促胰液素研究的患者。在这个联合系列的每例患者中，给予促胰液素后胃泌素峰值和胃泌素综合反应均增加，尽管有4例患者增加幅度较小。促胰液素缺乏生理抑制意味着胃泌素释放部位的肿瘤自主性。虽然胃泌素瘤患者通常可见对促胰液素的胃泌素反应增强，但从生理学角度来看，缺乏抑制构成阳性促胰液素抑制试验。积累的经验是一致的，表明该试验是高胃泌素血症鉴别诊断中的一项重要辅助检查。
