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Gastrin

Gastrin-secreting cells (G-cells) produce, store and release gastrin within the pyloric and upper duodenal mucosa. Gastrin stimulates gastric acid secretion by parietal cells and circulates in 2 active forms: gastrin-34 (G-34) and gastrin-17 (G-17). 
   
Determination of circulating gastrin concentrations can aid in the diagnosis of gastrinoma. Greater than 50% are malignant and approximately 25% occur as part of multiple endocrine neoplasia type 1 (MEN 1). The presence of gastrinoma and hypergastrinaemia resulting in severe refractory peptic ulcer disease is known as Zollinger-Ellison syndrome. 
  
Increased circulating gastrin concentrations can also occur as a result of reduced or absent gastric acid secretion e.g. H pylori infection, chronic atrophic gastritis +/- pernicious anaemia or long-term use of proton pump inhibitors (PPIs). This is due to the lack of inhibitory feedback of acid on the G-cells. Therefore elevated gastrin levels should be interpreted in relation to gastric acid secretion.
  
Sample Requirements and Reference Ranges
  
Sample type  Plasma
Container  Heparinised plasma (EDTA unsuitable)
Precautions  Sample should be collected after an overnight fast. Separate and freeze plasma. Transport frozen. Proton pump inhibitors should be discontinued for a week, and H2 blockers for 48 hours, prior to sampling. Icterus and lipaemia moderately reduce results.
Minimum volume  1 mL
Reference range  <115 ng/L (fasting)
Turnaround time  35 days
Method  Siemens Immulite. This assay measures both the G-17 isoform and, to a lesser extent, the G-34 isoform.
 
Quality Assurance
UK NEQAS
Last Updated: 28 November 2019