PMID- 34922358
OWN - NLM
STAT- MEDLINE
DCOM- 20220420
LR  - 20220606
IS  - 1945-7197 (Electronic)
IS  - 0021-972X (Linking)
VI  - 107
IP  - 5
DP  - 2022 Apr 19
TI  - Secretin Stimulation Test and Early Diagnosis of Gastrinoma in MEN1 Syndrome: 
      Survey on the MEN1 Florentine Database.
PG  - e2110-e2123
LID - 10.1210/clinem/dgab903 [doi]
AB  - CONTEXT: Multiple endocrine neoplasia type 1 (MEN1) is a rare inherited endocrine 
      cancer syndrome. Multiple gastro-entero-pancreatic neuroendocrine tumors 
      (GEP-NETs) affect 30% to 80% of MEN1 patients, with the most common functioning 
      GEP-NET being gastrinoma. Biochemical identification of hypergastrinemia may help 
      to recognize the presence of gastrinomas before they are detectable by 
      instrumental screening, enabling early diagnosis and start of therapy, preferably 
      before tumor progression and metastases occurrence. OBJECTIVE: Evaluate the 
      effectiveness of secretin stimulation test to precociously diagnose the presence 
      of gastrin-secreting tumors. DESIGN: Results of secretin stimulation tests, 
      performed between 1991 and February 2020, were retrospectively analyzed, as 
      aggregate, in a cohort of MEN1 patients with GEP-NETs. SETTING: Data were 
      extracted from the MEN1 Florentine database. PATIENTS: The study included 72 MEN1 
      patients with GEP-NETs who underwent a secretin stimulation test for the 
      evaluation of gastrin secretion. OUTCOMES: A positive secretin stimulation test 
      was assumed with a difference between basal fasting serum gastrin (FSG) and the 
      maximum stimulated value of gastrin over 120 pg/mL. RESULTS: The secretin 
      stimulation test showed a secretin-induced hypergastrinemia in 27.8% (20/72) of 
      patients with GEP-NETs, and a positive test in 18 cases. The test allowed the 
      identification of a positively stimulated hypergastrinemia in 75.0% (3/4) of 
      patients who presented a basal FSG within the normal range. CONCLUSIONS: 
      Diagnosis of gastrinoma is complex, difficult, and controversial. Results of this 
      study confirm that a positive secretin stimulation test allows early diagnosis of 
      gastrinomas, even in the presence of borderline or normal levels of nonstimulated 
      FSG.
CI  - (c) The Author(s) 2021. Published by Oxford University Press on behalf of the 
      Endocrine Society. All rights reserved. For permissions, please e-mail: 
      journals.permissions@oup.com.
FAU - Giusti, Francesca
AU  - Giusti F
AD  - Department of Experimental and Clinical Biomedical Sciences, University of 
      Florence, Florence, Italy.
FAU - Cioppi, Federica
AU  - Cioppi F
AD  - Azienda Ospedaliero Universitaria Careggi (AOUC), Florence, Italy.
FAU - Fossi, Caterina
AU  - Fossi C
AD  - Department of Experimental and Clinical Biomedical Sciences, University of 
      Florence, Florence, Italy.
FAU - Marini, Francesca
AU  - Marini F
AD  - Department of Experimental and Clinical Biomedical Sciences, University of 
      Florence, Florence, Italy.
AD  - F.I.R.M.O. Italian Foundation for Research on Bone Diseases, Florence, Italy.
FAU - Masi, Laura
AU  - Masi L
AD  - Azienda Ospedaliero Universitaria Careggi (AOUC), Florence, Italy.
FAU - Tonelli, Francesco
AU  - Tonelli F
AD  - F.I.R.M.O. Italian Foundation for Research on Bone Diseases, Florence, Italy.
FAU - Brandi, Maria Luisa
AU  - Brandi ML
AUID- ORCID: 0000-0002-8741-0592
AD  - F.I.R.M.O. Italian Foundation for Research on Bone Diseases, Florence, Italy.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Clin Endocrinol Metab
JT  - The Journal of clinical endocrinology and metabolism
JID - 0375362
RN  - 0 (Gastrins)
RN  - 1393-25-5 (Secretin)
SB  - IM
MH  - Early Detection of Cancer
MH  - *Gastrinoma/diagnosis/pathology
MH  - Gastrins
MH  - Humans
MH  - *Multiple Endocrine Neoplasia Type 1/pathology
MH  - *Pancreatic Neoplasms/diagnosis/pathology
MH  - Retrospective Studies
MH  - Secretin
MH  - *Zollinger-Ellison Syndrome/diagnosis/pathology
OTO - NOTNLM
OT  - FSG
OT  - MEN1
OT  - ZES
OT  - Zollinger-Ellison syndrome
OT  - fasting serum gastrin
OT  - gastrinoma
OT  - hypergastrinemia
OT  - multiple endocrine neoplasia type 1
OT  - secretin stimulation test
EDAT- 2021/12/19 06:00
MHDA- 2022/04/21 06:00
CRDT- 2021/12/18 20:34
PHST- 2021/08/26 00:00 [received]
PHST- 2021/12/19 06:00 [pubmed]
PHST- 2022/04/21 06:00 [medline]
PHST- 2021/12/18 20:34 [entrez]
AID - 6469542 [pii]
AID - 10.1210/clinem/dgab903 [doi]
PST - ppublish
SO  - J Clin Endocrinol Metab. 2022 Apr 19;107(5):e2110-e2123. doi: 
      10.1210/clinem/dgab903.