Creutzfeldt W, Creutzfeldt C, Frerichs H, Track N S, Arnold R
Horm Metab Res. 1976;Suppl 6:7-18.
Forty human insulin-producing tumors were investigated with histochemical, immunohistological and ultrastructural methods and extracted for insulin and proinsulin. These studies resulted in the following findings: 1) A variable number of tumor cells contained only a few or often no beta granules. 2) The insulin concentration was lower and the proinsulin percentage higher in insulinoma cells compared with normal beta-cells. 3) According to the ultrastructural appearance of the secretory granules four types of insulinoma were established. 4) Insulinomas frequently contained cells with atypical secretory granules which were Grimelius silver-positive. Their similarity to the Type IV islet cell and to cells regularly found in gastrinomas, Verner-Morrison tumors and glucagonomas suggests that all endocrine pancreatic tumors originate from a common precursor cell. 5) The morphological and biochemical findings support the theory that uncontrolled hormone release and/or decreased storage capacity are responsible for fasting hyperinsulinism in insulinoma patients. 6) The severity of hypoglycemia symptoms and the result of stimulatory tests were not related to the size, the insulin concentration and the total insulin content of the tumor.
采用组织化学、免疫组织学和超微结构方法对40例人胰岛素分泌肿瘤进行了研究，并提取了胰岛素和胰岛素原。这些研究得出了以下结果：1）不同数量的肿瘤细胞仅含有少量或通常不含β颗粒。2）与正常β细胞相比，胰岛素瘤细胞中的胰岛素浓度较低，胰岛素原百分比更高。3）根据分泌颗粒的超微结构外观，确定了四种类型的胰岛素瘤。4）胰岛素瘤经常含有具有非典型分泌颗粒的细胞，这些颗粒对Grimelius银染色呈阳性。它们与IV型胰岛细胞以及胃泌素瘤、韦尔纳-莫里森肿瘤和胰高血糖素瘤中常见的细胞相似，这表明所有内分泌胰腺肿瘤都起源于共同的前体细胞。5）形态学和生化研究结果支持这样的理论，即不受控制的激素释放和/或储存能力下降是胰岛素瘤患者空腹高胰岛素血症的原因。6）低血糖症状的严重程度和刺激试验结果与肿瘤的大小、胰岛素浓度和总胰岛素含量无关。
