胃泌素瘤临床病理分析

目的 　为提高临床对胃泌素瘤的诊断与治疗水平。方法 　对本院近 30年收治的 1 2例胃泌素瘤病例进行总结分析。结果 　本组胃泌素瘤患者除具有典型的高胃酸症状外 ,还具有以下有别于一般消化性溃疡的特点 :( 1 )腹泻 :多数病例 ( 7/1 2 )伴有严重腹泻 ,其中 1例出现休克 ;( 2 )多发性肿瘤 :3例患者伴有其它神经内分泌肿瘤 ;( 3)十二指肠多发结节 ( 3/1 2 ) :活检虽无异常 ,但有 2例经手术证实为粘膜下胃泌素瘤 ;( 4)多中心发生 :9例胃泌素瘤为多中心性 ,7例累及不同器官 ,以胰腺、胃、十二指肠多见 ;( 5 )多激素分泌 :6例患者中 5例分泌 2种以上激素 ;( 6 )部分病例对化疗相对敏感。结论　 胃泌素瘤可表现为多中心发生、多激素分泌的特性 ,应力争做到不漏掉肿瘤并积极治疗。

Clinicopathological Study on Gastrinoma

Objective To improve the clinical diagnosis and treatment of gastrinoma. Methods Twelve cases of gastrinoma found in the recent30 years in our hospital were analyzed.Re- sults The results indicated that in addition to the typical symptoms related to gastric acid overproduction,the frequency of certain uncommon features characteristic of the disease was unusually high in our hands i.e.,( 1 ) The majority of them( 7/1 2 ) had serious diarrhea,even resulting in shock.( 2 ) Multiple endocrine neoplasia type ( MEN) was in3out of1 2 associ- ated in our series.( 3) Multiple nodules in the duodenum( 3/1 2 ) were found and in two pa- tients were shown to be submucosal gastrinoma confirmed by pathology.( 4) Multifocal le- sions were found in 9out of 1 2 patients,and in 7cases at least two organs were involved. Most gastrinomas were located in the pancreas,stomach and duodenum.( 5 ) As reported by other authors,multiple hormone secretion was common:in five of six patients the tumor se- creted more than two hormones.( 6 ) In some cases,tumors were sensitive to chemotherapy. Conclusions In our series gastrinoma was found with the feature of multiple lesions and mu- tiple hormone secretion in addition to the typical symptoms related to gastric acid overpro- duction