aDepartment of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan bDigestive Diseases Branch, NIDDK, NIH, Bethesda, Maryland, USA.
Curr Opin Gastroenterol. 2013 Nov;29(6):650-61. doi: 10.1097/MOG.0b013e328365efb1.
To review the recent advances and current controversies in patients with Zollinger-Ellison syndrome (ZES).
Recent advances in the management of ZES include: improved understanding of the pathogenesis of gastrinoma and pancreatic neuroendocrine tumors, new prognostic classification systems, new diagnostic algorithms, more sensitive localization studies, new treatment strategies including improved control of gastric acid secretion and role for surgery, and new approaches to patients with advanced disease. Controversies include: the best approach to a patient with hypergastrinemia suspected of possibly having ZES, the appropriate gastrin assay to use, the role of surgery in patients with ZES, especially those with multiple endocrine neoplasia type 1, and the precise order of therapeutic modalities in the treatment of patients with advanced disease.
This review updates clinicians regarding important advances and controversies required to optimally diagnose and manage patients with ZES.
回顾 Zollinger-Ellison 综合征（ZES）患者的最新进展和当前争议。
ZES 管理方面的最新进展包括：对胃泌素瘤和胰腺神经内分泌肿瘤发病机制的理解加深、新的预后分类系统、新的诊断算法、更敏感的定位研究、新的治疗策略，包括胃酸分泌控制的改善和手术的作用，以及晚期疾病患者的新方法。争议包括：对疑似可能患有 ZES 的高胃泌素血症患者的最佳处理方法、使用的适当胃泌素检测方法、手术在 ZES 患者中的作用，尤其是多发性内分泌肿瘤 1 型患者，以及晚期疾病患者治疗中治疗方式的精确顺序。
本综述使临床医生了解诊断和治疗 ZES 患者所需的重要进展和争议，以达到最佳效果。
