ZOLLINGER-ELLISON SYNDROME, ACROMEGALY, AND COLORECTAL NEOPLASIA

Zollinger-Ellison syndrome (ZES) and acromegaly are two hypersecretory states in which colorectal neoplasia has been described, but the inci dence in the former condition may not be increased. We describe four p atients with colorectal neoplasia associated with the ZES and review o ther published cases. Tissue ELISA with Adnab-9 antibody, a putative c olorectal cancer risk marker, from a patient with ZES and from seven p atients with acromegaly was compared to 13 controls at average risk fo r colorectal neoplasia. The patient with ZES without detectable coloni c neoplasia and seven patients with acromegaly had increased binding o f Adnab-9 in the colonic mucosa by ELISA. The difference was significa nt for the acromegaly patients compared to the controls (p < 0.05). Th e accumulated 34 instances of colorectal neoplasia in ZES patients sug gests that this association may not be rare. Adnab-9 expression, detec table in both ZES and acromegaly, may reflect predisposition to colore ctal neoplasia in both hypersecretory states. Therefore, while a basis for association of colorectal neoplasia and hypergastrinemia exists, the clinical data are not compelling enough to warrant surveillance of patients with ZES. To resolve this problem, more definitive case cont rol studies should be conducted.