胰岛素瘤病理类型与胰岛素释放指数关系的探讨

目的探讨胰岛素瘤病理类型与胰岛素释放指数的关系,以提高临床对胰岛素瘤的诊断水平。方法回顾性分析32例胰岛素瘤患者的临床资料。结果良性胰岛素瘤18例,恶性胰岛素瘤8例,胰岛细胞增生6例,其胰岛素释放指数（IRVG）分别为：1.27±1．16、1．98±0．87、1．32±0．89,三组比较差异无统计学意义（P〉0．05）。18例良性胰岛素瘤中有5例的IRI／G比值≤0．3,且C肽水平〉300pmoL／L,而恶性胰岛素瘤和胰岛细胞增生的IRI／G比值均〉0．3。结论典型的Whipple三联征和IRI／G比值是胰岛素瘤最主要的诊断依据。在结合术前定位检查的基础上,应该多次检测、计算IRI／G比值,尤其是良性胰岛素瘤,以提高诊断水平。

Relationship between the Pathologic Types of Insulinoma and Insulin Release Index

Objective To explore the relationship between the pathology types of insulinoma and insulin release index. Methods The clinical data of 32 cases of insulinoma were analyzed retrospectively. Results 18 cases had benign insulinoma,8 eases had malignant insulinoma,and 6 cases had nesidioblastosis. The ratio of insulin to glucose （IRI/G） was lower than 0.3 ,but C-peptide level higher than 300 pmol/L in 5 cases of benign insulinoma. However,the IRI/G was higher than 0.3 in all of malignant insulinoma and nesidioblastosis. Conclusion Whipple＇s triad and IRI/G still play an important role in the diagnosis of an insulinoma. To prevent missing insulinoma,we suggest that IRI/G should be detected and repeatedly in the light of clinical symptoms.