PANCREATIC-POLYPEPTIDE IS A USEFUL PLASMA MARKER FOR RADIOGRAPHICALLYEVIDENT PANCREATIC-ISLET CELL TUMORS IN PATIENTS WITH MULTIPLE ENDOCRINE NEOPLASIA TYPE-1

Background. The usefulness of human pancreatic polypeptide (hPP) as a plasma marker for islet cell neoplasms is controversial. We sought to determine the relation between fasting plasma hPP levels and radiograp hically detectable pancreatic islet cell tumors in patients with multi ple endocrine neoplasia type Methods. Fasting plasma hPP levels were m easured prospectively in 202 individuals from 31 independent kindreds with MEN 1. Plasma levels greater than 3.0 times the normal age-specif ic values were defined as elevated. Patients with elevated plasma hPP levels were evaluated with computed tomographic scanning and magnetic resonance imaging, octreotide scanning; or selective angiography. Resu lts. Twenty-two patients had elevated fasting plasma hPP levels, and 2 0 of these patients were evaluated radiographically. Pancreatic lesion s were detected in 19 patients. A group of eight patients with normal basal fasting plasma hPP levels were evaluated with computed tomograph y, magnetic resonance imaging; octreotide scanning, or selective angio graphy based on clinical presentation. One patient in this group had a n imaging study that was positive for a pancreatic lesion. Conclusions . The presence of a markedly elevated fasting plasma hPP level in pati ents with MEN 1 is 95% sensitive and 88% specific for the presence of radiographically detectable pancreatic islet cell tumors.