Zollinger R M, Martin E W, Carey L C, Sparks J, Minton J P
Ann Surg. 1976 Oct;184(4):525-30. doi: 10.1097/00000658-197610000-00016.
Over a period of 21 years 39 patients with gastrinoma were surgically treated. Thirty-three patients had total gastrectomy with two postoperative deaths, and 6 patients had a lesser procedure. The postoperative fasting gastrin levels remained elevated and did not always indicate the extent of tumor involvement. Further mobilization of tumor gastrin by provocative infusion of calcium gluceptate, 15 mg/kg of body weight, should be carried out routinely. A hepatic angiogram should be considered when the gastrin levels exceed 1,000 picograms per ml. Chemotherapy consisting of Tubercidin, Streptozotocin and 5-Fluorouracil was given to 5 patients with extensive gastrinoma. All patients felt better and gained from three to 35 pounds in weight. Since 60% of the patients died or have definite evidence of tumor activity it is assumed that the tumor growth was not inhibited and that it is malignant. Approximately 40% of the patients seem to do well despite modest elevations in gastrin levels suggesting that the retained tumor could be considered benign.
在21年的时间里，39例胃泌素瘤患者接受了手术治疗。33例患者接受了全胃切除术，术后有2例死亡，6例患者接受了较小的手术。术后空腹胃泌素水平仍然升高，并不总是表明肿瘤累及的范围。应常规通过静脉注射葡萄糖酸钙（15mg/kg体重）来进一步激发肿瘤胃泌素的释放。当胃泌素水平超过1000皮克/毫升时，应考虑进行肝血管造影。5例广泛胃泌素瘤患者接受了由结核菌素、链脲佐菌素和5-氟尿嘧啶组成的化疗。所有患者感觉良好，体重增加了3至35磅。由于60%的患者死亡或有明确的肿瘤活动证据，因此推测肿瘤生长未受抑制，且为恶性。尽管胃泌素水平略有升高，但约40%的患者似乎情况良好，这表明残留的肿瘤可被视为良性。
