Table 8.
Comparison of ZES Clinical/lab/tumoral features in patients with or without VB12 deficiency.
| Number (% Total Group) | |||
|---|---|---|---|
| VB12 Deficiency | |||
| Yes | No | p-Value | |
| Characteristic | (n = 37) | (n = 138) | |
| I. Clinical features/disease course | |||
| Age at study (yrs.) (Mean ± SEM) (a) | 54.1 ± 2.0 | 53.7 ± 1.0 | 0.93 |
| Male gender | 24 (65%) | 67 (49%) | 0.096 |
| Race | |||
| White | 30 (81%) | 107 (78%) | 0.82 |
| Nonwhite | 7 (19%) | 31 (23%) | |
| Age at ZES onset (yrs.) (Mean ± SEM) (a) | 40.3 ± 2.0 | 39.8 ± 1.0 | 0.71 |
| Presenting symptom (a) | |||
| Pain | 29 (78%) | 106 (77%) | 0.99 |
| GERD | 15 (40%) | 72 (52%) | 0.27 |
| Diarrhea | 32(86%) | 108 (78%) | 0.36 |
| MEN-1 present (a) | 9 (24%) | 36 (26%) | 0.84 |
| Duration (yrs.) (mean ± SEM) | |||
| Time ZES onset to study | 13.8 ± 1.3 | 13.7 ± 0.7 | 0.93 |
| II. LABORATORY RESULTS | |||
| BAO (mEq/h) (Mean ± SEM) (b) | 41.7 ± 3.8 | 42.2 ± 2.2 | 0.82 |
| MAO (mEq/h) (Mean ± SEM) (c) | 57.3 ± 4.8 | 66.2 ± 2.9 | 0.10 |
| # Previous gastric acid-reducing surgery) (a) | 2 (5.4%) | 9 (6.5%) | 0.99 |
| Fasting serum gastrin (FSG) (pg/mL)) | |||
| Mean ± SEM | 1953 ± 401 | 2921 ± 1090 | 0.84 |
| (Range) | (172–8900) | (52–110,000) | |
| Median | 742 | 597 | |
| III. TUMORAL FEATURES | |||
| Tumor extent | |||
| Overall tumor localization (d and e) | |||
| Localized disease | 29 (78%) | 106 (77%) | 0.99 |
| Not localized | 8 (22%) | 32 (23%) | |
| Specific tumor extent (e and f) | |||
| Primary only | 10 (27%) | 58 (42%) | 0.13 |
| Primary and lymph node metastases | 17 (46%) | 42 (30%) | 0.082 |
| Primary and liver metastases | 8 (22%) | 31 (22%) | 0.99 |
| Not established: no surgery | 2 (5.4%) | 7 (5.1%) | 0.99 |
| Primary tumor location (f) | |||
| Duodenum | 21 (55%) | 66 (48%) | 0.47 |
| Pancreas | 8 (22%) | 22 (16%) | 0.46 |
| Lymph node primary (g) | 5 (14%) | 17 (12%) | 0.78 |
| Other (h) | 2 (5%) | 10 (7%) | 0.99 |
| Unknown (i) | 6 (16%) | 30 22%) | 0.65 |
Abbreviations: BAO-Basal acid output; MAO- Maximal acid output; FSG-serum fasting gastrin. (a) See legends in Table 1, Table 2, Table 3, Table 4, Table 5 and Table 6 for an explanation of variables. (b) A total of 163 patients had a preoperative BAO (152 with no gastric surgery and 11 with previous gastric acid-reducing surgery) determined as described previously [104,150]. (c) A total of 143 patients had an MAO (133 with no gastric surgery and 10 with previous gastric acid-reducing surgery) determined as described previously [104,150]. (d) Localized disease included patients with regional disease without distant metastases as defined previously [171]. (e) General tumor extent determined by imaging and surgery in all patients as described previously [103,171,172]. Specific localization in 9 patients with regional disease could not be determined because no surgery was performed. (f) The primary tumor site was established during surgery or endoscopy or by imaging as described previously [167,174,175,177]. (g) Primary lymph node gastrinomas were identified as described previously [103]. (h) Non-pancreatic-duodenal/lymph node primary sites occurred, as described previously, in the hepato-biliary tract [102,180], ovary, jejunum, mesentery, heart, lung cancer, and gastric antrum [103,181,182,183]. (i) Patients with diffuse liver metastases, with MEN1/ZES, or severe co-morbidities did not undergo routine surgical exploration, as described previously [151,159,178], and the primary location, if not clearly identified on the imaging/endoscopy, was listed as the primary site unknown.