ANTRAL-GASTRIN-CELL HYPERPLASIA IN PEPTIC-ULCER DISEASE

Differences in the plasma-gastrin response and in the appearances of the antra under immunofluorescence were striking and it is suggested that antral-G-cell hyperplasia may be a separate clinical entity.

Abstract

Thirteen patients with chronic pepticulcer disease (two with duodenal ulcer and eleven with recurrent ulceration after previous gastric surgery) were studied. In each patient plasma-gastrin was measured before and after meat-extract ('Oxo') test meal. In six patients (group A) fasting plasma-gastrin was 497±44 pg. per ml. (mean±S.D.) and in the other seven (group B) it was 185±9 pg. per ml. Peak gastrin concentration after oxo was 1304±179 pg. per ml. in group A and 405±20 pg. per ml. in group B. The integrated gastrin response was 2490±808 pg. and 601±70 pg. in groups A and B, respectively. The differences between the means for all three measurements were statistically significant. At laparotomy none of the patients had a pancreatic tumour. A hemigastrectomy was performed in each patient. The gastrin (G) cells in the resected antrum were examined by a specific immunofluorescence technique. All the patients with hypergastrinæmia (group A) had numerous G cells in their antra, whereas the patients in group B had significantly fewer G cells. Although the number of patients in each group was relatively small, these differences in the plasma-gastrin response and in the appearances of the antra under immunofluorescence were striking. It is suggested that antral-G-cell hyperplasia may be a separate clinical entity.