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ISSN 1028-4818 (Electronic)

2022, Number 2

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Mul Med 2022; 26 (2)

Laboratory and imaging diagnostic methods in the Zollinger-Ellison syndrome

Leyva MMÁ, Serrano GNB, Teruel GR

Language: Spanish
References: 66
Page:
PDF size: 283.57 Kb.


ABSTRACT

Introduction: Zollinger-Ellison syndrome is a neuroendocrine tumor that produces hypersecretion of gastric acid and peptic ulcer. Therefore, the review was carried out with the objective of describing the main laboratory and imaging diagnostic methods in Zollinger-Ellison syndrome.
Development: a bibliographic review was carried out with the descriptors in Spanish and English "Zollinger-Ellison syndrome", "neuroendocrine tumor" and gastrinoma, taken from the descriptors in health sciences (DeCS / MeSH), in Google databases. Academic, SciELO and National Library of Medicine. As results, it was obtained that the laboratory methods are fasting basal serum gastrin, which is not reliable due to its alteration in different diseases, gastric pH, excludes secondary hypergastrinemias, and basal acid gastric secretion, which differentiates the forms of hypergastrinemia. These laboratory tests are complementary to each other, and to perform them, the intake of proton pump inhibitors must be suspended. Other tests include the secretin stimulation test, which confirms hypergastrinemia, and the calcium stimulation test, which diagnoses tumors >1 mm that express calcium receptors. Imaging methods are essential for tumor localization. The first imaging technique to be performed due to its high sensitivity and specificity is 111In-octreotide scintigraphy, which locates tumors not detected with other examinations and allows differential diagnosis with hypervascularized lesions.
Conclusions: Zollinger-Ellison syndrome requires the use of novel laboratory and imaging methods for an accurate diagnosis.


REFERENCES

  1. Ferrandino Carballo F, Umaña Brenes AA. Síndrome de Zollinger - Ellison. Med Leg Costa Rica. 2016; 33(1): 275-81

  2. González López R, Ramírez Castañeda J, Ortega Jiménez JA, García Cano E, Palacios Rojo M, Núñez González RA, et al. Gastrinoma hepático primario, presentación de caso extremadamente raro y su resolución quirúrgica, en un hospital de tercer nivel en México. Cir Cir. 2022; 90(1): 109-13.

  3. Nath AL, Saxena N, Kulkarni B, Borwankar S, Lahoti H, Oak S. Zollinger-Ellison syndrome in a 12-year-old child. J Indian Assoc Pediatr Surg. 2017; 22(3):168-9.

  4. Cho MS, Kasi A. Zollinger Ellison Syndrome. Stat Pearls [Internet]. 2021 [citado 4/4/2022]. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK537344/4. .

  5. Metz DC, Cadiot G, Poitras P, Ito T, Jensen RT. Diagnosis of Zollinger-Ellison syndrome in the era of PPIs, faulty gastrin assays, sensitive imaging and limited access to acid secretory testing. Int J Endocr Oncol. 2017; 4(4): 167-85.

  6. Poblocki J, Jasinska A, Syrenicz A, Andrysiak Mamos E, Szczuko M. The Neuroendocrine Neoplasms of the Digestive Tract: Diagnosis, Treatment and Nutrition. Nutrients. 2020; 12(5):1437-58.

  7. Stolniceanu CR, Grierosu IC, Matovic M, Stefanescu C. Somatostatin receptor molecular imaging in a misdiagnosed gastrinoma case. World J Nucl Med. 2020; 19(4): 417-20.

  8. Pirasteh A, Lovrec P, Bodei L. Imaging of neuroendocrine tumors: A pictorial review of the clinical value of different imaging modalities. Rev Endocr Metab Disord. 2021; 22(3): 539-52.

  9. Beltrán MA. Síndrome de Zollinger-Ellison: revisión del conocimiento actual. Rev Colomb Cir. 2016; 31 (3): 197-211.

  10. Rossi RE, Elvevi A, Citterio D, Coppa J, Invernizzi P, Mazzaferro V, et. al. Gastrinoma and Zollinger Ellison syndrome: A roadmap for the management between new and old therapies. World J Gastroenterol. 2021; 27(35): 5890-5907.

  11. Lee L, Ramos Alvarez I, Ito T, Jensen RT. Insights into Effects/Risks of Chronic Hypergastrinemia and Lifelong PPI Treatment in Man Based on Studies of Patients with Zollinger-Ellison Syndrome. Int J Mol Sci. 2019; 20(20): 5128-73.

  12. Moreno García S, Caicedo Durán AC, Losada Trujillo N, García González EJ. Gastrinoma. Revisión de tema. Morfolia. 2018; 10(1): 10-26.

  13. Cingam SR, Botejue M, Hoilat GJ. Gastrinoma. En: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 . Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK441842/13. .

  14. Guzmán YF, López RP, Vera A, González Devia D. Herramientas para el abordaje diagnóstico de los tumores neuroendocrinos de páncreas. Rev Colomb Cir. 2018; 33(1): 79-99.

  15. Nguyen M. Gastrinoma. En: Manual MSD versión para profesionales [Internet]. Estados Unidos: Merck Sharp & Dohme Corp; 2019. [citado 26/07/2021]. Disponible en: https://www.msdmanuals.com/es-ec/professional/trastornos-gastrointestinales/tumores-del-aparato-digestivo/gastrinoma15. .

  16. O´Connor J, Acosta Haab G, Armas I, Belli S, Bruno G, Cabanne A, et al. Recomendaciones para el diagnóstico y el tratamiento de tumores neuroendocrinos de origen gastroenteropancreáticos. Reunión intersociedades, Academia Nacional de medicina. Acta Gastroenterol Latinoam. 2020; 50 (sup.1): 3-35.

  17. Rehfeld JF. Gastrin and the Moderate Hypergastrinemias. Int J Mol Sci. 2021; 22(13): 6977-89.

  18. Díaz Aguirregoitia J, Echenique Elizondo M. Gastrinoma de localización anatómica »,» ®,® §,§ ­,­ ¹,¹ ²,² ³,³ ß,ß Þ,Þ þ,þ ×,× Ú,Ú ú,ú Û,Û û,û Ù,Ù ù,ù ¨,¨ Ü,Ü ü,ü Ý,Ý ý,ý ¥,¥ ÿ,ÿ ¶,¶ normal »,» ®,® §,§ ­,­ ¹,¹ ²,² ³,³ ß,ß Þ,Þ þ,þ ×,× Ú,Ú ú,ú Û,Û û,û Ù,Ù ù,ù ¨,¨ Ü,Ü ü,ü Ý,Ý ý,ý ¥,¥ ÿ,ÿ ¶,¶ . Rev. esp. enferm. dig. 2005; 97(2): 138-9.

  19. Romera López AL, Rodríguez Morillas D, Martínez Domínguez AP, López Cantarero Ballesteros M, Pérez Ramón JA, et al. Gastrinomas: tratamiento quirúrgico: indicaciones y opciones técnicas. Cir Andal. 2009; 20: 37-43.

  20. Norton JA, Foster DS, Ito T, Jensen RT. Gastrinomas: Medical or Surgical Treatment. Endocrinol Metab Clin North Am. 2018; 47(3): 577-601.

  21. Shah I, Vyas N, Kadkhodayan KS. Zollinger Ellison Syndrome in a Patient with Multiple Endocrine Neoplasia Type 1: A Classic Presentation. Case Rep Gastrointest Med. [Internet]. 2019 [citado 20/03/2021]; 2019. Disponible en: https://doi.org/10.1155/2019/960576921. .

  22. Köseoglu H, Duzenli T, Sezikli M. Gastric neuroendocrine neoplasms: A review. World J Clin Cases. 2021; 9(27): 7973-85.

  23. Rivillas Reyes JF, Castro Avendaño JL, Martínez Muñoz HF. Zollinger-Ellison Syndrome. Case Report. Case Reports. 2019; 5(1): 28-35.

  24. Hayashi R, Minami I, Sasahara Y, Izumiyama H, Yoshimoto T, Kishino M, et al. Diagnostic accuracy of selective arterial calcium injection test for localization of gastrinoma. Endocr J. 2020; 67(3): 305-15.

  25. Hofland J, Kaltsas G, de Herder WW. Advances in the Diagnosis and Management of Well-Differentiated Neuroendocrine Neoplasms. Endocr Rev. 2020; 41(2): 371-403.

  26. Lee L, Ito T, Jensen RT. Imaging of pancreatic neuroendocrine tumors: recent advances, current status, and controversies. Expert Rev Anticancer Ther. 2018; 18(9):837-60.

  27. Ponthaud C. de, Menegaux F, Gaujoux S. Updated Principles of Surgical Management of Pancreatic Neuroendocrine Tumours (pNETs): What Every Surgeon Needs to Know. Cancers. 2021; 13: 5969- 89.

  28. Lorenzo D, Maire F, Hentic O, Prat F, Ruszniewski P, Mestier L. de. Endoscopic diagnosis and treatment of neuroendocrine tumors. Current Opinion in Endocrine and Metabolic Research. 2021; 18: 201-6.

  29. Ovejero Herrero L, Ibáñez Clemente P. Arteriografía [Internet]. Barcelona: Asociación Española de Enfermería Vascular y Heridas; 2018. [citado 22/03/2020]. Disponible en: https://aeevh.org/profesionales/hospitalizacion/arteriografia/29. .

  30. Tsoli M, Chatzellis E, Koumarianou A, Kolomodi D, Kaltsas G. Current best practice in the management of neuroendocrine tumors. Ther Adv Endocrinol Metab. [Internet]. 2019 [citado 22/03/2020]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6378464/pdf/10.1177_2042018818804698.pdf30. .

  31. Shao QQ, Zhao BB, Dong LB, Cao HT, Wang WB. Surgical management of Zollinger-Ellison syndrome: Classical considerations and current controversies. World J Gastroenterol. 2019; 25(32): 4673-81.

  32. Fernández-Cruz L, Pelegrina A. Cirugía del gastrinoma: Resultados inmediatos y a largo plazo. Cir Esp. 2015; 93(6): 390-5.

  33. Chin JL, O'Toole D. Diagnosis and Management of Upper Gastrointestinal Neuroendocrine Tumors. Clin Endosc. 2017; 50(6): 520-9.

  34. Ferrandino Carballo F, Umaña Brenes AA. Síndrome de Zollinger - Ellison. Med Leg Costa Rica. 2016; 33(1): 275-81

  35. González López R, Ramírez Castañeda J, Ortega Jiménez JA, García Cano E, Palacios Rojo M, Núñez González RA, et al. Gastrinoma hepático primario, presentación de caso extremadamente raro y su resolución quirúrgica, en un hospital de tercer nivel en México. Cir Cir. 2022; 90(1): 109-13.

  36. Nath AL, Saxena N, Kulkarni B, Borwankar S, Lahoti H, Oak S. Zollinger-Ellison syndrome in a 12-year-old child. J Indian Assoc Pediatr Surg. 2017; 22(3):168-9.

  37. Cho MS, Kasi A. Zollinger Ellison Syndrome. Stat Pearls [Internet]. 2021 [citado 4/4/2022]. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK537344/4. .

  38. Metz DC, Cadiot G, Poitras P, Ito T, Jensen RT. Diagnosis of Zollinger-Ellison syndrome in the era of PPIs, faulty gastrin assays, sensitive imaging and limited access to acid secretory testing. Int J Endocr Oncol. 2017; 4(4): 167-85.

  39. Poblocki J, Jasinska A, Syrenicz A, Andrysiak Mamos E, Szczuko M. The Neuroendocrine Neoplasms of the Digestive Tract: Diagnosis, Treatment and Nutrition. Nutrients. 2020; 12(5):1437-58.

  40. Stolniceanu CR, Grierosu IC, Matovic M, Stefanescu C. Somatostatin receptor molecular imaging in a misdiagnosed gastrinoma case. World J Nucl Med. 2020; 19(4): 417-20.

  41. Pirasteh A, Lovrec P, Bodei L. Imaging of neuroendocrine tumors: A pictorial review of the clinical value of different imaging modalities. Rev Endocr Metab Disord. 2021; 22(3): 539-52.

  42. Beltrán MA. Síndrome de Zollinger-Ellison: revisión del conocimiento actual. Rev Colomb Cir. 2016; 31 (3): 197-211.

  43. Rossi RE, Elvevi A, Citterio D, Coppa J, Invernizzi P, Mazzaferro V, et. al. Gastrinoma and Zollinger Ellison syndrome: A roadmap for the management between new and old therapies. World J Gastroenterol. 2021; 27(35): 5890-5907.

  44. Lee L, Ramos Alvarez I, Ito T, Jensen RT. Insights into Effects/Risks of Chronic Hypergastrinemia and Lifelong PPI Treatment in Man Based on Studies of Patients with Zollinger-Ellison Syndrome. Int J Mol Sci. 2019; 20(20): 5128-73.

  45. Moreno García S, Caicedo Durán AC, Losada Trujillo N, García González EJ. Gastrinoma. Revisión de tema. Morfolia. 2018; 10(1): 10-26.

  46. Cingam SR, Botejue M, Hoilat GJ. Gastrinoma. En: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 . Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK441842/13. .

  47. Guzmán YF, López RP, Vera A, González Devia D. Herramientas para el abordaje diagnóstico de los tumores neuroendocrinos de páncreas. Rev Colomb Cir. 2018; 33(1): 79-99.

  48. Nguyen M. Gastrinoma. En: Manual MSD versión para profesionales [Internet]. Estados Unidos: Merck Sharp & Dohme Corp; 2019. [citado 26/07/2021]. Disponible en: https://www.msdmanuals.com/es-ec/professional/trastornos-gastrointestinales/tumores-del-aparato-digestivo/gastrinoma15. .

  49. O´Connor J, Acosta Haab G, Armas I, Belli S, Bruno G, Cabanne A, et al. Recomendaciones para el diagnóstico y el tratamiento de tumores neuroendocrinos de origen gastroenteropancreáticos. Reunión intersociedades, Academia Nacional de medicina. Acta Gastroenterol Latinoam. 2020; 50 (sup.1): 3-35.

  50. Rehfeld JF. Gastrin and the Moderate Hypergastrinemias. Int J Mol Sci. 2021; 22(13): 6977-89.

  51. Díaz Aguirregoitia J, Echenique Elizondo M. Gastrinoma de localización anatómica »,» ®,® §,§ ­,­ ¹,¹ ²,² ³,³ ß,ß Þ,Þ þ,þ ×,× Ú,Ú ú,ú Û,Û û,û Ù,Ù ù,ù ¨,¨ Ü,Ü ü,ü Ý,Ý ý,ý ¥,¥ ÿ,ÿ ¶,¶ normal »,» ®,® §,§ ­,­ ¹,¹ ²,² ³,³ ß,ß Þ,Þ þ,þ ×,× Ú,Ú ú,ú Û,Û û,û Ù,Ù ù,ù ¨,¨ Ü,Ü ü,ü Ý,Ý ý,ý ¥,¥ ÿ,ÿ ¶,¶ . Rev. esp. enferm. dig. 2005; 97(2): 138-9.

  52. Romera López AL, Rodríguez Morillas D, Martínez Domínguez AP, López Cantarero Ballesteros M, Pérez Ramón JA, et al. Gastrinomas: tratamiento quirúrgico: indicaciones y opciones técnicas. Cir Andal. 2009; 20: 37-43.

  53. Norton JA, Foster DS, Ito T, Jensen RT. Gastrinomas: Medical or Surgical Treatment. Endocrinol Metab Clin North Am. 2018; 47(3): 577-601.

  54. Shah I, Vyas N, Kadkhodayan KS. Zollinger Ellison Syndrome in a Patient with Multiple Endocrine Neoplasia Type 1: A Classic Presentation. Case Rep Gastrointest Med. [Internet]. 2019 [citado 20/03/2021]; 2019. Disponible en: https://doi.org/10.1155/2019/960576921. .

  55. Köseoglu H, Duzenli T, Sezikli M. Gastric neuroendocrine neoplasms: A review. World J Clin Cases. 2021; 9(27): 7973-85.

  56. Rivillas Reyes JF, Castro Avendaño JL, Martínez Muñoz HF. Zollinger-Ellison Syndrome. Case Report. Case Reports. 2019; 5(1): 28-35.

  57. Hayashi R, Minami I, Sasahara Y, Izumiyama H, Yoshimoto T, Kishino M, et al. Diagnostic accuracy of selective arterial calcium injection test for localization of gastrinoma. Endocr J. 2020; 67(3): 305-15.

  58. Hofland J, Kaltsas G, de Herder WW. Advances in the Diagnosis and Management of Well-Differentiated Neuroendocrine Neoplasms. Endocr Rev. 2020; 41(2): 371-403.

  59. Lee L, Ito T, Jensen RT. Imaging of pancreatic neuroendocrine tumors: recent advances, current status, and controversies. Expert Rev Anticancer Ther. 2018; 18(9):837-60.

  60. Ponthaud C. de, Menegaux F, Gaujoux S. Updated Principles of Surgical Management of Pancreatic Neuroendocrine Tumours (pNETs): What Every Surgeon Needs to Know. Cancers. 2021; 13: 5969- 89.

  61. Lorenzo D, Maire F, Hentic O, Prat F, Ruszniewski P, Mestier L. de. Endoscopic diagnosis and treatment of neuroendocrine tumors. Current Opinion in Endocrine and Metabolic Research. 2021; 18: 201-6.

  62. Ovejero Herrero L, Ibáñez Clemente P. Arteriografía [Internet]. Barcelona: Asociación Española de Enfermería Vascular y Heridas; 2018. [citado 22/03/2020]. Disponible en: https://aeevh.org/profesionales/hospitalizacion/arteriografia/29. .

  63. Tsoli M, Chatzellis E, Koumarianou A, Kolomodi D, Kaltsas G. Current best practice in the management of neuroendocrine tumors. Ther Adv Endocrinol Metab. [Internet]. 2019 [citado 22/03/2020]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6378464/pdf/10.1177_2042018818804698.pdf30. .

  64. Shao QQ, Zhao BB, Dong LB, Cao HT, Wang WB. Surgical management of Zollinger-Ellison syndrome: Classical considerations and current controversies. World J Gastroenterol. 2019; 25(32): 4673-81.

  65. Fernández-Cruz L, Pelegrina A. Cirugía del gastrinoma: Resultados inmediatos y a largo plazo. Cir Esp. 2015; 93(6): 390-5.

  66. Chin JL, O'Toole D. Diagnosis and Management of Upper Gastrointestinal Neuroendocrine Tumors. Clin Endosc. 2017; 50(6): 520-9.




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