胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤,因其临床表现多样,导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用,拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点,以期有助于提高影像学的诊断准确率和降低漏诊率,尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料,检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例,通过查阅病例的方法,提取出胰岛素瘤的大小和解剖分布等数据,进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例,其中,男45例、女71例,年龄13～76岁,平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%),单发45例、多发1例;体尾部68例(58.6%),单发65例、多发3例;全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm,平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例,≤3 cm 15例,>3 cm 3例。年龄与肿瘤的大小相关,≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm,P<0.05。头颈部的肿瘤大于体尾部的肿瘤,头颈部肿瘤平均大小(1.66±0.63)cm,体尾部(1.42±0.52)cm,P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发;绝大多数单发,但可以全胰腺多发;多数小于1.5 cm,肿瘤的大小与患者年龄和肿瘤的解剖分布相关。

Analysis of characteristics of insulinoma anatomic of distribution

ObjectiveInsulinoma is the most common pancreatic neuroendocrine tumor. Because of its diverse clinical manifestations, diagnosis is difficult.Imaging diagnosis, especially endoscopic ultrasonography(EUS) plays an important role in the diagnosis of insulinoma, with high sensitivity and specificity.Clarifying the anatomical distribution characteristics of insulinomas will help to improve the diagnostic accuracy of imaging and reduce the rate of missed diagnoses, and it will be more valuable for EUS beginners in education and training practice. MethodsTo review the clinical data of patients diagnosed with insulinoma by surgical pathology from January 1993 to November 2019 in our hospital, searching for cases with postoperative pathological diagnosis of "insulinoma" by consulting medical records.The data of the size and anatomical distribution of insulinoma are extracted to further analyze its characteristics. ResultsA total of 116 patients were diagnosed with insulinoma including 45 males and 71 females, (13-76)years with an average age of (44.4 ± 14.85) years. There were 110 single cases of insulinoma (94.8%) and 6 multiple cases (5.2%). Location distribution: 46 cases (39.7%) were in the head and neck with 45 single cases and 1 multiple case; 68 cases were in the body and tail (58.6%) with 65single cases and 3multiple cases; in 2 pateints, multiple tumors were found in the entire pancreas (1.7%). Size of the lesion: the diameter was 0.4 ~ 3.4cm, and the average size was (1.53 ± 0.58)cm. There were 29 cases ≤1 cm, 41 cases of> 1 cm and ≤1.5 cm, 28 cases of> 1.5 cm and ≤2.0 cm, 15 cases of ≤3 cm, and 3 cases of> 3 cm. The age is related to the size of the tumor.The size of tumors for patients ≤44 years old were (1.36 ± 0.51), and that for patients>44 years old was (1.7 ± 0.6) cm, P<0.05.Tumors in the head and neck were larger than thosein the body and tail.The average size of tumors in the head and neck was (1.66±0.63)cm, and (1.42 ± 0.52)cm in the body and tail, P<0.05. ConclusionsInsulinoma occurs more frequently in the body and tail of the pancreas than in the head and neck; The vast majority of tumors are single, but can be multiple distributing in the entire pancreas; Most inluslinomas are less than 1.5 cm, and the size of the tumor is related to the age of the patients and the anatomical distribution of the tumor.