胰高血糖素瘤诊断与治疗

目的 提高对GCGN的认识，改善其诊治水平，方法 总结国内献GCGN25例及本院4例的诊治资料。结果 86.2%(25/29)患有典型的GCGN特征，但几乎所有患在病程的不同阶段曾被误诊，其中行胰体尾切除18例，Whipple手术及胆肠吻合各1例，肿瘤局部切除或除术2例，7例不适宜手术或拒绝手术治疗，病理结果示24例恶性，3例良性，3例性质不确定，治疗后多数患短期内皮疹消退，症状改善，随访生存期超过2年以上的患有5例。结论 GCGN临床少见，尤其缺乏特征性临床表现极易误诊，影像学检查及GC测定有助于诊断，根治性或姑息性切除辅以化疗等措施为有效的治疗手段。

Glucagonoma syndrome: Review of the Chinese literature

Objective To get a better understanding of GCGN syndrome so as to improve diagnosis and treatment of the condition. Methods Twenty-nine cases of GCGN were retrospectively reviewed. Results Although 85 percent of these patients had typical symptoms of GCGN?almost all the 29 cases were misdiagnosed at different stages of the condition. Distal pancreatectomy was performed in 18 cases, Whipple procedure in one, cholecystojejunostomy in one, local tumor resection or enucleation in two; the remaining seven patients were either inoperable or refused to undergo surgical operation. Pathological study showed that, of the 29 GCGN cases, 24 were malignant, 3 were benign, and the remaining two were not confirmed in nature. In most patients who received treatment, rashes subsided within days of treatment and the associated symptoms were ameliorated; follow-up revealed that there were 5 patients who had survived more than two years. Conclusions GCGN cases were often misdiagnosed because of clinical rarity, especially those lacking characteristic manifestations. Imageological study and detection of plasma GC are helpful for the diagnosis of the condition. Radical or palliative resection of the tumor in combination with chemotherapy is effective for the treatment of GCGN.