The application of the radio-immunoassay of gastrin to surgical practice

The role of gastrin in surgical practice is explored using a gastrin radioimmunoassay. The gastrin level for this assay is less than 80 ng/l in normal subjects, 24.7 +- 16.8 ng/l in duodenal ulcer patients and 68.6 +- 44.3 ng/l in gastric ulcer patients. Vagotomy increased the level of gastrin, while gastric resection reduced the level. An insulin test meal increased the level of gastrin before and after a complete vagotomy. The level of gastrin is not related to acid secretion. After the injection of insulin, the level of gastrin decreased. No relationship is noted between the gastrin level and acid or the symptoms of dumping after a glucose meal; at 90 and 120 minutes the gastrin levels fell below basal. The gastrin responses to a series of meals did not reveal statistical differences between normal and duodenal ulcer subjects. However, the pattern of response over a 24 hour period is biologically different when six normal subjects are compared to six duodenal patients. Finally, in a series of patients with suspected Zollinger Ellison Syndrome, serial fasting gastrin levels and a secretin test were adequate for the diagnosis of this syndrome. (author)