Prinz R A, Badrinath K, Chejfec G, Freeark R J, Greenlee H B
Am Surg. 1983 Jul;49(7):345-9.
Although most pancreatic islet cell tumors are associated with clinically evident hormone hypersecretion, a small group have no obvious signs or symptoms of excess endocrine activity and are termed "nonfunctioning." The clinical course of eight patients with "nonfunctioning" islet cell carcinoma seen during an eight-year period was reviewed. The six men and two women ranged in age from 36 to 68 years (mean--52). The initial complaint in six was a palpable abdominal mass associated with pain, steatorrhea, or jaundice. Two patients presented with abdominal pain that was initially thought to be of biliary tract origin, and the tumor was discovered at operation. Two patients underwent radical distal pancreatectomy and have no gross evidence of residual or recurrent tumor one and two years later. Five had a biopsy and biliary diversion; three of these also had a gastrojejunostomy. Five were given postoperative 5-fluorouracil and streptozotocin chemotherapy. One developed renal dysfunction and was switched to dimethyltriazenoimidazole carboxamide (DTIC) chemotherapy. Three patients are alive four, six, and eight years, respectively, after diagnosis. Two expired two and a half and three years after diagnosis. One patient had only biopsy of peripancreatic nodes, and he expired in one year. "Nonfunctioning" islet cell carcinoma presents with symptoms related to the mass effects of the tumor. An aggressive therapeutic approach utilizing surgery and chemotherapy is advocated for these slow growing neoplasms.
虽然大多数胰岛细胞瘤与临床上明显的激素分泌过多有关，但一小部分没有明显的内分泌活动亢进的体征或症状，被称为“无功能性”。回顾了8年间所见的8例“无功能性”胰岛细胞癌患者的临床病程。6名男性和2名女性年龄在36至68岁之间（平均52岁）。6例患者最初的主诉是可触及的腹部肿块，伴有疼痛、脂肪泻或黄疸。2例患者最初表现为腹痛，最初被认为是胆道起源，手术时发现肿瘤。2例患者接受了根治性远端胰腺切除术，1年和2年后没有肉眼可见的残留或复发肿瘤证据。5例患者进行了活检和胆道改道；其中3例还进行了胃空肠吻合术。5例患者术后接受了5-氟尿嘧啶和链佐星化疗。1例出现肾功能不全，改用二甲基三氮烯咪唑甲酰胺（DTIC）化疗。3例患者分别在诊断后4年、6年和8年存活。2例在诊断后2年半和3年死亡。1例患者仅对胰腺周围淋巴结进行了活检，1年后死亡。“无功能性”胰岛细胞癌表现出与肿瘤占位效应相关的症状。对于这些生长缓慢的肿瘤，提倡采用手术和化疗的积极治疗方法。
