McGuigan J E
Monogr Pathol. 1980;21:177-84.
It has now been well established that the ulcerogenic syndrome associated with non-beta islet cell tumors of the pancreas is due to excess gastrin release and consequent marked gastric acid hypersecretion. The clinical manifestations may be similar to, but are often more severe and recurrent than, common peptic ulcer. The diagnosis of gastrinoma in patients with this clinical syndrome can be established principally by demonstration of fasting hypergastrinemia, and by application of provocative tests with measurement of serum gastrin in response to intravenous calcium infusion, intravenous secretin injection and feeding of a standard meal. Gastrinomas are usually located within the pancreas, are often multifocal and metastatic, but may be primary in non-pancreatic sites. There is substantial heterogeneity in the molecular forms of circulating and gastrinoma gastrin. Although hypergastrinemia is characteristic of gastrinoma, serum gastrin levels may be increased in disorders other than gastrinoma. Techniques are available to document the presence of gastrin in islet cell tumors and, thereby, to establish these as gastrinomas.
现已明确，与胰腺非β胰岛细胞瘤相关的致溃疡综合征是由于胃泌素过度释放以及随之而来的显著胃酸分泌过多所致。其临床表现可能与普通消化性溃疡相似，但往往更严重且反复发作。对于患有这种临床综合征的患者，胃泌素瘤的诊断主要可通过证实空腹高胃泌素血症，以及应用激发试验，测量静脉输注钙、静脉注射促胰液素和进食标准餐后血清胃泌素的反应来确立。胃泌素瘤通常位于胰腺内，常为多灶性且具有转移性，但也可能原发于非胰腺部位。循环中的胃泌素和胃泌素瘤胃泌素的分子形式存在很大异质性。虽然高胃泌素血症是胃泌素瘤的特征，但血清胃泌素水平在胃泌素瘤以外的疾病中也可能升高。现有技术可用于证明胰岛细胞瘤中胃泌素的存在，从而将这些肿瘤确定为胃泌素瘤。
