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- Title
Prospective study of the ability of histamine, serotonin or serum chromogranin A levels to identify gastric carcinoids in patients with gastrinomas.
- Authors
Bashir, S.; Gibril, F.; Ojeaburu, J. V.; Asgharian, B.; Entsuah, L. K.; Ferraro, G.; Crafa, P.; Bordi, C.; Jensen, R. T.
- Abstract
Background: Chronic hypergastrinaemia causes gastric enterochromaffin cell proliferation and carcinoid tumours. The only reliable means to diagnose enterochromaffin cell changes/carcinoids is by biopsy. Aim: To assess whether serum histamine, chromogranin A or serotonin and urinary N -methylimidazoleacetic acid or 5-hydroxyindoleacetic acid correlate with advanced enterochromaffin cell changes or gastric carcinoids in patients with gastrinomas. Methods: Consecutive patients (n =145) had the above assays and endoscopy with gastric biopsies. Results: Lower N -methylimidazoleacetic acid and chromogranin A levels ( P < 0.0001) occurred in disease-free patients. In patients with active disease, the fasting serum gastrin levels correlated ( P < 0.0001) with both chromogranin A and N -methylimidazoleacetic acid levels. Chromogranin A ( P =0.005), but not N -methylimidazoleacetic acid, serotonin, 5-hydroxyindoleacetic acid or histamine levels, correlated with the enterochromaffin cell index. Carcinoids, but not advanced enterochromaffin cell changes only, were associated with higher chromogranin A and N -methylimidazoleacetic acid levels. Conclusions: Serum chromogranin A levels and urinary N -methylimidazoleacetic acid levels, but not serum histamine or serotonin or urinary 5-hydroxyindoleacetic acid, correlate with the presence of gastric carcinoids. However, no assay identified patients with advanced enterochromaffin cell changes only with high sensitivity/specificity. Thus, N -methylimidazoleacetic acid and chromogranin A levels are unable to identify patients with advanced changes in enterochromaffin cells and therefore neither can replace routine gastric biopsies.
- Subjects
HISTAMINE; SEROTONIN; CARCINOID; THERAPEUTICS
- Publication
Alimentary Pharmacology & Therapeutics, 2002, Vol 16, Issue 7, p1367
- ISSN
0269-2813
- Publication type
Article
- DOI
10.1046/j.1365-2036.2002.01249.x