中国全科医学2017，Vol.20Issue(11)：1386-1388,3.DOI:10.3969/j.issn.1007-9572.2017.11.022
18例胰岛细胞瘤的临床特点及诊治体会
Clinical Features and Diagnosis and Treatment Experience of 18 Patients with Islet Cell Tumor
周俊伟 1郭晓惠 1杨建梅 1吴红花 1董爱梅 1袁戈恒 1姚军 1王薇 1高燕明 1张俊清1
作者信息
- 1. 100034北京市,北京大学第一医院内分泌科
- 折叠
摘要
Abstract
Objective To investigate the clinical features,diagnosis,treatment,and outcome of the patients with islet cell tumor.Methods We conducted a retrospective analysis of the data about clinical features,diagnosis,treatment,and outcome of 18 cases with islet cell tumor admitted to Peking University First Hospital from January 2000 to April 2013.Results In the 18 patients,the male to female ratio was 1:2;median age was 51 years (between 18 and 83 years old).Two cases had non-functioning islet cell tumor,the other 16 cases had insulinoma,a kind of functional islet cell tumor,including 2 cases accompanied with diabetes.Whipple's triad was found in all the patients with insulinoma:plasma glucose level was 0.85-2.56 mmol/L and insulin value was ＞ 10 mU/L in all the patients measured at the time of the symptoms;insulin release index was ＞ 0.4 in 11 cases and insulin release corrected index was ＞ 100 in 14 cases in the diagnosis of insulinoma.The positive of B ultrasonography in 5 cases and that of enhanced CT scan in 11 cases in tumor localization.Endoscopic ultrasonography,percutaneous transhepatic portal catheterization (PTPC) segment sampling and B ultrasonography and segmental blood sampling during exploratory laparotomy were performed in 3 patients with negative B ultrasonography and CT scan for diagnosing the disease further.Surgical treatment was performed in 17 cases with islet cell tumor,specifically,local resection was carried out in 10 cases,resection of the body and tail of the pancreas was implemented in 6 cases,and Whipple procedure was performed in 1 case.After surgery,no serious complications occurred in the patients and the plasma glucose levels of them returned.Conclusion The majority type of islet cell tumor is functional insulinoma,which is sometimes accompanied with diabetes.Whipple's triad and the measurement of serum insulin and insulin release index are needed in the diagnosis.Contrast-enhanced CT scan can be used in the localization with a high accuracy.Most patients are benign and can be cured with surgery.关键词
腺瘤,胰岛细胞/胰岛素瘤/诊断/治疗Key words
Adenoma, islet cell/Insulinoma/Diagnosis/Therapy分类
医药卫生引用本文复制引用
周俊伟,郭晓惠,杨建梅,吴红花,董爱梅,袁戈恒,姚军,王薇,高燕明,张俊清..18例胰岛细胞瘤的临床特点及诊治体会[J].中国全科医学,2017,20(11):1386-1388,3.
