Pancreatic polypeptide is a useful plasma marker for radiographically evident 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 radiographically detectable pancreatic islet cell tumors in patients with multiple endocrine neoplasia type 1 (MEN 1).


METHODS
Fasting plasma hPP levels were measured prospectively in 202 individuals from 31 independent kindreds with MEN 1. Plasma levels greater than 3.0 times the normal age-specific 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.


RESULTS
Twenty-two patients had elevated fasting plasma hPP levels, and 20 of these patients were evaluated radiographically. Pancreatic lesions were detected in 19 patients. A group of eight patients with normal basal fasting plasma hPP levels were evaluated with computed tomography, magnetic resonance imaging, octreotide scanning, or selective angiography based on clinical presentation. One patient in this group had an imaging study that was positive for a pancreatic lesion.


CONCLUSIONS
The presence of a markedly elevated fasting plasma hPP level in patients with MEN 1 is 95% sensitive and 88% specific for the presence of radiographically detectable pancreatic islet cell tumors.
Mutch
M G
MG
Department of Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA.
Frisella
M M
MM
DeBenedetti
M K
MK
Doherty
G M
GM
Norton
J A
JA
Wells
S A
SA
Lairmore
T C
TC
D007516:Adenoma, Islet Cell / Q000175:diagnosis*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D002648:Child; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D018761:Multiple Endocrine Neoplasia Type 1 / Q000175:diagnosis*; D010190:Pancreatic Neoplasms / Q000175:diagnosis*; D010191:Pancreatic Polypeptide / Q000097:blood*; D014057:Tomography, X-Ray Computed
D014408:Biomarkers, Tumor; D010191:Pancreatic Polypeptide