Value of Serum Gastrin in the Diagnosis of the Zollinger-Ellison Syndrome

Summary: Serum gastrin has been measured by radioimmunoassay in 300 consecutive patients with known or suspected Zollinger-Ellison syndrome. Thirty of these patients had an elevated serum gastrin between 320 pg/ml and 200 ng/ml; the remainder had levels below 250 pg/ml. Of the 30 patients, 14 had histologically proven Zollinger-Ellison syndrome, eight had suspected Zollinger-Ellison syndrome but without histological proof, seven had histologically proven Zollinger-Ellison tumours with either hyperparathyroidism (4) or insulinoma (3) and one patient had a retained excluded antrum. These results illustrate the relative rarity of the Zollinger-Ellison syndrome but also highlight the importance of serum gastrin estimation in the correct diagnosis of the syndrome. The high mortality from inadequate surgery makes this diagnosis mandatory.