Canto Jairala J A, Herrera M F, Gamboa-Domínguez A, Angeles-Angeles A, Uscanga L, Robles-Díaz G, Rull J A, Campuzano M
Departamento de Cirugía, Instituto Nacional de la Nutrición Salvador Zubirán, México, D.F.
Rev Invest Clin. 1997 Jan-Feb;49(1):25-30.
To analyze characteristics of patients with endocrine tumors of the pancreas seen between 1960 and 1992 at the Instituto Nacional de la Nutrición.
MATERIAL & METHODS: The clinical records of 38 patients with endocrine tumors of the pancreas were reviewed. Overall characteristics, diagnostic studies, intraoperative findings, treatment and outcome were analyzed. The archival histological specimens were revised and immunohistochemical stainings were performed in the non-functioning tumors.
Twenty patients had hyperinsulinism, 10 non-functioning tumors, and eight a Zollinger-Ellison syndrome. The mean age of patients with hyperinsulinism was 38 years (8 males and 12 females); 18 were sporadic and two associated with MEN I syndrome. In 16 patients an insulinoma was removed: (6 in the head, 5 in the body, 5 in the tail of the pancreas). A cure was documented in 14 patients with sporadic tumors but not in the two cases associated with MEN I; 15 tumors were benign. Three patients with the Zollinger-Ellison syndrome were males and five females with a mean age of 41 years. Seven tumors were sporadic and one associated with the MEN I syndrome; 70% were located in the gastrinoma triangle. Local excision was performed in five and gastrectomy in three. The cure rate was 60% and malignancy was documented in 40%. Two males and eight females with a mean age of 30 years had non-functioning tumors (9 sporadic and one associated to MEN I). There was a positive immunohistochemistry in 60% of the tumors; 90% were malignant and the cure rate was 10%.
Insulinoma is the most common endocrine tumor of the pancreas in our hospital. The cure rate for insulinomas, gastrinomas and non-functioning tumors was 90%, 60% and 10% and malignancy was documented in 5%, 40% and 90% respectively.
分析1960年至1992年间在国家营养研究所就诊的胰腺内分泌肿瘤患者的特征。
回顾了38例胰腺内分泌肿瘤患者的临床记录。分析了总体特征、诊断研究、术中发现、治疗及结果。对存档的组织学标本进行复查,并对无功能性肿瘤进行免疫组织化学染色。
20例患者有高胰岛素血症,10例为无功能性肿瘤,8例为佐林格-埃利森综合征。高胰岛素血症患者的平均年龄为38岁(8例男性和12例女性);18例为散发性,2例与MEN I综合征相关。16例患者切除了胰岛素瘤:(6例位于胰头,5例位于胰体,5例位于胰尾)。14例散发性肿瘤患者治愈,但2例与MEN I相关的病例未治愈;15例肿瘤为良性。3例佐林格-埃利森综合征患者为男性,5例为女性,平均年龄41岁。7例肿瘤为散发性,1例与MEN I综合征相关;70%位于胃泌素瘤三角区。5例行局部切除,3例行胃切除术。治愈率为60%,40%为恶性。2例男性和8例女性,平均年龄30岁,患有无功能性肿瘤(9例散发性,1例与MEN I相关)。60%的肿瘤免疫组织化学呈阳性;90%为恶性,治愈率为10%。
胰岛素瘤是我院最常见的胰腺内分泌肿瘤。胰岛素瘤、胃泌素瘤和无功能性肿瘤的治愈率分别为90%、60%和10%,恶性率分别为5%、40%和90%。