Table 1.
Comparison of clinical characteristics, laboratory data and tumor features in 293 ZES patients seen at NIH and 537 ZES patients from the literature who underwent gastrin provocative testing.
| No. (%)* | |||
|---|---|---|---|
| Characteristic | NIH | Literature | p |
|
| |||
| Number of patients | 293 | 537 | |
| Male gender | 160/293 (55) | 264/436 (61) | 0.11 |
| Age at evaluation (yr) | |||
| Mean ± SEM [Range] | 47.9 ± 0.6 [15–71] | 46.3 ± 0.65 [15–80] | 0.15 |
| MEN1 present | 85/293 (29) | 105/489 (21) | 0.017† |
| Previous acid-reducing surgery‡ | 44 (15) | 93 (17) | 0.39 |
| Acid secretion (no previous acid-reducing surgery)§ | |||
| BAO (mEq/hr) | |||
| Mean ± SEM [Range] | 43.4 ± 1.6 [1.8–159] | 28.8 ± 1.7 [1.9–143] | 0.0077† |
| MAO (mEq/hr) | |||
| Mean ± SEM [Range] | 63.5 ± 2.1 [3.8–159] | 52.1 ± 2.3 [4–149] | <0.0001† |
| Acid secretion (previous acid-reducing surgery)** | |||
| BAO (mEq/hr) | |||
| Mean ± SEM [Range] | 27.1 ± 3.1 [2–94] | 16.5 ± 1.7 [1–66] | 0.0009† |
| MAO (mEq/hr) | |||
| Mean ± SEM [Range] | 38.3 ± 4.8 [2–140] | 29.4 ± 3.2 [3–90] | 0.14 |
| Gastrin†† | |||
| Fold fasting serum gastrin‡‡ | |||
| Median [Range] | 6.37 [0.96–5500] | 4.83 [0.13–50000] | <0.0001† |
| Δ secretin (pg/ml) | |||
| Median [Range] | 744 [0–3000000] | 600 [−536–4000000] | 0.048† |
| Δ calcium (pg/ml) | |||
| Median [Range] | 850 [–10–208000] | 994 [0–168000] | 0.29 |
| Δ meal (pg/ml) | |||
| Median [Range] | 212 [−40000–60000] | 132 [−1750–35102] | 0.082 |
| Primary tumor localization | |||
| Pancreatic | 81/293 (28) | 107/300 (36) | 0.036† |
| Duodenum | 110/293 (38) | 68/300 (23) | <0.0001† |
| Other§§ | 36/293 (12) | 35/300 (12) | 0.81 |
| Unknown*** | 78/293 (27) | 96/300 (32) | 0.15 |
| Tumor extent | |||
| Localized disease)††† | 247/293 (84) | 160/227 (70) | 0.0004† |
| Distant metastases ‡‡‡ | 46/293 (16) | 67/227 (30) | 0.0004† |
Abbreviations: ZES: Zollinger-Ellison syndrome, NIH: National Institutes of Health, yr: years, SEM: standard error of the mean, MEN1: multiple endocrine neoplasia type 1, BAO: basal acid output, MAO: maximal acid output.
Numbers in denominator are numbers of patients with data available.
indicates a significant difference (p<0.05).
Including patients with partial gastrectomy (literature 66, NIH 23), vagotomy/drainage (literature 45, NIH 17) and total gastrectomy (literature 15, NIH 6).
BAO data from 230 literature and 240 NIH patients, MAO data from 152 literature and 202 NIH patients without previous acid-reducing surgery.
BAO data from 73 literature and 39 NIH patients, MAO data from 45 literature and 36 NIH patients with previous acid-reducing surgery..
Data on fasting serum gastrin available for all patients, secretin tests for 355 literature and 279 NIH patients, calcium stimulation for 212 literature and 207 NIH patients, the meal test data for 112 literature and 229 NIH patients. The Δ calculated for the stimulation tests corresponds to the difference between the gastrin value showing the greatest change after stimulation and the basal gastrin value.
Expressed in fold of the highest normal value.
‘Other’ includes 16 primary tumors of the lymph node, 4 gastric, 6 ovary, 5 liver, 2 jejunal for the literature data; 20 lymph node, 5 liver, 3 stomach 2 bile duct, 2 heart, 1 jejunum, 1 omentum and 1 lung tumor for the NIH patients.
‘Unknown’ includes patients without tumor evidence on imaging studies who did not undergo surgical exploration or for whom surgical data was not available.
Only patients with no evidence of liver or other distant metastases
Including 60 patients with liver metastases, 1 lung, 3 bone, 1 peritoneal and 1 duodenal for the literature patients and 45 liver metastases for the NIH patients.