M. Orbuch et al., PROLONGED HYPERGASTRINEMIA DOES NOT INCREASE THE FREQUENCY OF COLONICNEOPLASIA IN PATIENTS WITH ZOLLINGER-ELLISON SYNDROME, Digestive diseases and sciences, 41(3), 1996, pp. 604-613
Whereas considerable experimental evidence suggests chronic hypergastr
inemia can increase the occurrence of colonic neoplasia, the risks in
man remain unclear, Zollinger-Ellison syndrome (ZES) is associated wit
h marked plasma elevation of all forms of gastrin and, because of its
prolonged course, has been shown to be an excellent model disease to s
tudy the effects of chronic hypergastrinemia in man, To determine whet
her profound chronic hypergastrinemia affects the occurrence of coloni
c dysplasia and neoplasia, 97 consecutive patients with ZES were studi
ed, All patients underwent colonoscopic examination to the cecum, and
the location, size: and type of polyps/tumors were determined, The pat
ients had a mean fasting gastrin level 31 times above normal and a mea
n disease duration of 10 years, 17/97 (18%) had adenomatous polyps, 67
/97 (69%) no adenomatous polyps, and 2/97 (2%) had adenocarcinoma of t
he colon, These rates were within ranges reported in a number of colon
oscopy and/or autopsy studies for asymptomatic controls. Stratificatio
n by age or gender, presence of MEN-I, tumor extent, and duration or d
egree of hypergastrinemia did not increase prevalence. This stud!: sho
ws that despite prolonged? profound hypergastrinemia, no increased rat
e of colonic neoplasia (polyps or cancer) was noted, These data sugges
t that the development of hypergastrinemia secondary to continuous use
of H+,K+-ATPase inhibitors for as long as 10 years is unlikely to cau
se an increased risk of developing colonic neoplasia in man.