Kimura W, Kuroda A, Morioka Y
First Department of Surgery, University of Tokyo, Japan.
Dig Dis Sci. 1991 Jul;36(7):933-42. doi: 10.1007/BF01297144.
A clinicopathological analysis of endocrine tumors of the pancreas, using 800 autopsy cases (422 men, 378 women, mean age 78.7) was accomplished. The results were: (1) Endocrine tumors and similar lesions were found in 3% or 24 cases (25 lesions). Twenty lesions (20 cases) were found to be tumors and five lesions (five cases) were determined to be hyperplasia of Langerhans islets. (2) Incidence of tumor was 10% (6/60) in individuals having histological studies of all sections of the pancreas, and 1.6% (12/738) in individuals having histological studies of three random sections of the pancreas. (3) None of the cases with tumors and hyperplastic lesions showed symptoms of hormone production. (4) Immunohistochemical analysis revealed hormone production in all 20 tumor cases and multiple hormone production was found in 14 of these (70%). (5) Ductular or tubular structures were found in or adjacent to the tumors in 12 cases (60%) and hyperplasia in one case (20%). Langerhans islets, 500 microns or larger in size, were found in three lesions of the tumor (15%). Langerhans islets with the mean diameter of normal islets + 2 SD or larger also were found around five tumors (25%) and three hyperplasias (60%). The above findings suggest that endocrine tumors of the pancreas are prevalent and that they do not produce symptoms of excessive hormone production even though they do continue to produce hormones. Some of the endocrine tumors or hyperplasias develop from totipotent stem cells of the duct epithelia, and factors promoting the growth of Langerhans islets might exist.
对800例尸检病例（422例男性，378例女性，平均年龄78.7岁）的胰腺内分泌肿瘤进行了临床病理分析。结果如下：（1）在内分泌肿瘤及类似病变中，3%即24例（25个病灶）被发现。其中20个病灶（20例）被确定为肿瘤，5个病灶（5例）被判定为朗格汉斯胰岛增生。（2）对胰腺所有切片进行组织学研究的个体中肿瘤发生率为10%（6/60），对胰腺随机三个切片进行组织学研究的个体中肿瘤发生率为1.6%（12/738）。（3）所有肿瘤和增生性病变病例均未表现出激素分泌症状。（4）免疫组织化学分析显示，所有20例肿瘤病例均有激素分泌，其中14例（70%）存在多种激素分泌。（5）12例（60%）肿瘤内或肿瘤旁发现导管或管状结构，1例（20%）增生内发现导管或管状结构。在3个肿瘤病灶（15%）中发现大小为500微米或更大的朗格汉斯胰岛。在5个肿瘤（25%）和3个增生（60%）周围也发现了平均直径为正常胰岛+2标准差或更大的朗格汉斯胰岛。上述发现表明，胰腺内分泌肿瘤很常见，即使它们持续分泌激素，也不会产生激素分泌过多的症状。一些内分泌肿瘤或增生可能起源于导管上皮的全能干细胞，并且可能存在促进朗格汉斯胰岛生长的因素。
