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胰腺的功能侧:胰岛素瘤综述。

The functioning side of the pancreas: a review on insulinomas.

机构信息

Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi University Hospital, Alma Mater Studiorum University of Bologna, Via Massarenti 9, 40138, Bologna, Italy.

NET Team Bologna ENETS Center of Excellence, S. Orsola-Malpighi University Hospital, Alma Mater Studiorum University of Bologna, Via Massarenti 9, 40138, Bologna, Italy.

出版信息

J Endocrinol Invest. 2020 Feb;43(2):139-148. doi: 10.1007/s40618-019-01091-w. Epub 2019 Jul 31.

Abstract

PURPOSE

Insulinomas are a rare type of neuroendocrine tumors, originating in the pancreas, difficult to diagnose and to treat. Due to its rarity, insulinomas are a not well-known pathological entity; thus, the diagnostic process is frequently a medical challenge with many possible differential diagnoses. The diagnostic process varies between non-invasive procedures, such as the fasting test or imaging techniques, and invasive ones. Insulinomas are rarely malignant, but the glycemic imbalance correlated with this tumor can frequently alter the quality of life of the patients and the consequent hypoglycemia can be extremely dangerous. Moreover, insulinomas can be associated with different genetic syndromes, such as Multiple Endocrine Neoplasia 1, accompanied by other specific symptoms. There are many different treatment strategies, depending on the need to control symptoms or control diseases progression, the only curative one being surgery.

METHODS AND RESULTS

We reviewed the evidences present in the literature on insulinomas and reported its main clinical characteristics and management strategies.

CONCLUSION

The aim of this review of the literature is to present the current knowledge on insulinomas, exploring the main clinical characteristics, the diagnostic tools, and the therapeutic strategies.

摘要

目的

胰岛素瘤是一种罕见的神经内分泌肿瘤,起源于胰腺,难以诊断和治疗。由于其罕见性,胰岛素瘤是一种不太为人知的病理实体;因此,诊断过程常常是一个具有许多可能鉴别诊断的医学挑战。诊断过程在非侵入性程序(如禁食试验或影像学技术)和侵入性程序之间有所不同。胰岛素瘤很少是恶性的,但与这种肿瘤相关的血糖失衡常常会改变患者的生活质量,随之而来的低血糖可能极其危险。此外,胰岛素瘤可能与不同的遗传综合征相关,如多发性内分泌腺瘤 1 型,并伴有其他特定症状。有许多不同的治疗策略,具体取决于控制症状或控制疾病进展的需要,唯一的治愈方法是手术。

方法和结果

我们回顾了文献中关于胰岛素瘤的证据,并报告了其主要临床特征和管理策略。

结论

本次文献复习旨在介绍目前关于胰岛素瘤的知识,探讨其主要临床特征、诊断工具和治疗策略。

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