Staren E D, Steinecker G A, Gould V E
J Surg Oncol. 1987 Aug;35(4):249-52. doi: 10.1002/jso.2930350408.
We describe a patient with a pancreatic islet carcinoma presenting with spinal cord compression owing to vertebral metastases. Subsequent studies demonstrated a typical islet cell carcinoma by light microscopy. By electron microscopy, the neurosecretory granules were morphologically suggestive of glucagon production. Radioimmunoassay studies revealed markedly elevated levels of serum glucagon. Notably, the patient did not exhibit the characteristic glucagonoma syndrome. This case exemplifies clearly that elevated levels of immunoreactive neuropeptide hormones are not necessarily associated with overt hormonal syndromes. Possible mechanisms for explaining this apparent discrepancy include the production of immunoreactive molecules with weak or absent systemic biological activity. Nevertheless, the determination of immunoreactive hormone levels in neuroendocrine neoplasms is an extremely effective adjunct method for their diagnosis and monitoring.
我们描述了一名胰岛细胞癌患者，该患者因椎体转移而出现脊髓压迫。随后的研究通过光学显微镜证实为典型的胰岛细胞癌。通过电子显微镜观察，神经分泌颗粒在形态上提示产生胰高血糖素。放射免疫分析研究显示血清胰高血糖素水平显著升高。值得注意的是，该患者并未表现出典型的胰高血糖素瘤综合征。此病例清楚地表明，免疫反应性神经肽激素水平升高并不一定与明显的激素综合征相关。解释这种明显差异的可能机制包括产生具有微弱或无全身生物学活性的免疫反应性分子。然而，测定神经内分泌肿瘤中的免疫反应性激素水平是用于其诊断和监测的极其有效的辅助方法。
