Nakamura Akinobu, Mitsuhashi Tomoko, Takano Yoshinari, Miyoshi Hideaki, Kameda Hiraku, Nomoto Hiroshi, Nagai So, Hatanaka Yutaka, Shimizu Chikara, Terauchi Yasuo, Atsumi Tatsuya
Division of Rheumatology, Endocrinology and Nephrology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Endocr J. 2016;63(2):135-42. doi: 10.1507/endocrj.EJ15-0371. Epub 2015 Nov 14.
We investigated the relationship between the results of the octreotide test and somatostatin receptor (SSTR) 2 expression in insulinoma patients, to evaluate the usefulness of this test for predicting SSTR2 expression in insulinomas in Japanese patients. Five females and one male were included in the study. All patients underwent the octreotide test before the surgery carried out to resect the tumor, and histopathological examination of the resected tumor was performed by a single experienced pathologist. SSTR2 expression was evaluated by the SSTR2 immunohistochemistry scoring system. Insulinoma was clinically diagnosed and surgically resected in all six patients. In the octreotide test, suppression of insulin secretion was sufficient after loading in patients 1-4 and 6. In patient 5, however, the suppression of insulin secretion was insufficient, which resulted in severe hypoglycemia with endogenous relative hyperinsulinemia after the octreotide loading. The histopathological findings revealed SSTR2 expression in the insulinomas of patients 1-4 and 6, but not in the insulinoma of patient 5. In conclusion, improvement of hyperinsulinemic hypoglycemia by octreotide in Japanese insulinoma patients was associated with SSTR2 expression in the tumor. Our results suggest that the octreotide test could be useful for predicting SSTR2 expression in the tumor.
我们研究了胰岛素瘤患者中奥曲肽试验结果与生长抑素受体（SSTR）2表达之间的关系，以评估该试验对预测日本患者胰岛素瘤中SSTR2表达的有用性。研究纳入了5名女性和1名男性。所有患者在进行肿瘤切除手术前均接受了奥曲肽试验，并且由一名经验丰富的病理学家对切除的肿瘤进行组织病理学检查。通过SSTR2免疫组织化学评分系统评估SSTR2表达。所有6例患者的胰岛素瘤均经临床诊断并手术切除。在奥曲肽试验中，患者1 - 4和6在注射后胰岛素分泌抑制充分。然而，患者5的胰岛素分泌抑制不足，导致奥曲肽注射后出现严重低血糖伴内源性相对高胰岛素血症。组织病理学结果显示，患者1 - 4和6的胰岛素瘤中有SSTR2表达，而患者5的胰岛素瘤中未检测到。总之，日本胰岛素瘤患者中奥曲肽改善高胰岛素血症性低血糖与肿瘤中SSTR2表达相关。我们的结果表明，奥曲肽试验可能有助于预测肿瘤中SSTR2的表达。
