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胰岛素瘤临床特征、诊断及治疗结果的多中心研究:来自15家医疗中心的见解

Multicenter Study on the Clinical Characteristics, Diagnosis, and Treatment Outcomes of Insulinoma: Insights From 15 Medical Centres.

作者信息

Topsakal Şenay, Yaylalı Güzin Fidan, Yarar Zeliha, Merdin Fatma Avcı, Karslı Seda, Çiftçi Sema, Ertürk Mehmet Sercan, Pamuk Barış Önder, Yavuz Ayşe Özdemir, Uğur Kader, Bilen Ogün, Zuhur Sayid Shafi, Engin İsmail, Güven Mehmet, Cesur Fazıl Mustafa, Fakı Sevgül, Polat Şefika Burçak, Çakır Bekir, Özışık Hatice, Kocabaş Gökçen Ünal, Erdoğan Mehmet, Çetinkalp Şevki, Koçar İlkcan Çerçi, Akbay Esen, Yarman Sema

机构信息

Department of Endocrinology and Metabolism, Faculty of Medicine, Pamukkale University, Denizli, Türkiye.

Department of Endocrinology and Metabolism, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Türkiye.

出版信息

Clin Endocrinol (Oxf). 2025 Jul;103(1):57-65. doi: 10.1111/cen.15255. Epub 2025 Apr 25.

Abstract

OBJECTIVE

This study aimed to evaluate the clinical characteristics, diagnostic approaches, and treatment outcomes of insulinoma patients from diverse regions across the country. We conducted a retrospective analysis of medical records from 76 adult patients diagnosed with insulinoma between 2018 and 2023 at 15 medical centres. Data collected included demographics, presenting symptoms, laboratory and imaging results, surgical reports, pathology findings, and clinical follow-up information.

DESIGN

Multi-centre retrospective study.

METHODS

The study revealed that key factors such as age, BMI, symptom duration, tumour size, and follow-up period were similar across genders. The majority of patients experienced neuroglycopenic symptoms, particularly during fasting. Insulinoma was typically diagnosed either during fasting or spontaneously, with no significant gender differences in glucose and insulin levels during hypoglycemia. However, men exhibited higher C-peptide levels (p < 0.05). Common comorbidities included hypertension, hypothyroidism, and cardiovascular conditions, and some patients had been using antiepileptics or antidepressants before their diagnosis.

RESULTS

Preoperative tumour diagnoses were largely accurate, with endoscopic ultrasound (EUS) being the most effective method. Most tumours were small ( < 2 cm) and located in the pancreas body, with the majority being solitary. Surgical treatments primarily involved enucleation or distal pancreatectomy. Follow-up data indicated high remission rates, with low rates of nonremission and mortality.

CONCLUSION

This study emphasises that early diagnosis and intervention, particularly in patients with a history of neurological or psychiatric issues, postprandial symptoms, or rapid symptom improvement after treatment, can lead to significantly better outcomes.

摘要

目的

本研究旨在评估来自全国各地不同地区的胰岛素瘤患者的临床特征、诊断方法及治疗结果。我们对2018年至2023年间在15家医疗中心确诊为胰岛素瘤的76例成年患者的病历进行了回顾性分析。收集的数据包括人口统计学信息、症状表现、实验室及影像学检查结果、手术报告、病理检查结果以及临床随访信息。

设计

多中心回顾性研究。

方法

研究显示,年龄、体重指数、症状持续时间、肿瘤大小及随访时间等关键因素在不同性别间相似。大多数患者出现神经低血糖症状,尤其是在空腹时。胰岛素瘤通常在空腹时或自发情况下被诊断出来,低血糖期间血糖和胰岛素水平在不同性别间无显著差异。然而,男性的C肽水平较高(p < 0.05)。常见的合并症包括高血压、甲状腺功能减退及心血管疾病,部分患者在确诊前曾使用抗癫痫药或抗抑郁药。

结果

术前肿瘤诊断大多准确,内镜超声(EUS)是最有效的方法。大多数肿瘤较小(< 2 cm),位于胰体部,多数为单发。手术治疗主要包括摘除术或胰体尾切除术。随访数据显示缓解率较高,未缓解率和死亡率较低。

结论

本研究强调,早期诊断和干预,尤其是对于有神经或精神疾病史、餐后症状或治疗后症状迅速改善的患者,可带来显著更好的治疗结果。

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