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目的 探讨胃泌素瘤的诊断治疗经验。方法 对本院 1978年 1月至 1998年 5月收治的 17例胃泌素瘤资料进行回顾性研究。结果 17例中 3例为多发内分泌腺瘤Ⅰ型 (MENⅠ )。肿瘤分布广泛 ,其中胰腺内 31% (5 / 16 )、十二指肠内 2 5 % (4/ 16 )、淋巴结内 19% (3/ 16 ) ,其他部位2 5 % (4/ 16 )。B型超声、CT对肝脏和胰腺内病灶敏感性较高 ,但对十二指肠及淋巴结内较小的病灶检出率低 ,对此可进一步采用血管造影、经皮经肝门脉胃泌素测定、核素显影等检查。17例中 16例共行手术治疗 38次。多次手术占 5 6 %。全胃切除 7例 (7/ 17,41% )。 15例平均随诊 6年 5个月 ,5年生存率 87% (13/ 15 )。结论 提高本病的早期诊断 ,争取肿瘤切除和减少肝脏转移是改善预后的关键。
Objective To investigate the experience of diagnosis and treatment of gastrinoma. Methods A retrospective study of 17 cases of gastrinoma treated in our hospital from January 1978 to May 1998 was performed. Results Among the 17 cases, 3 cases were multiple endocrine adenoma type I (MENI). The tumors were widely distributed, including 31% (5/16) in the pancreas, 25% (4/16) in the duodenum, 19% (3/16) in the lymph nodes, and 25% (4/16) in other sites. B-mode ultrasound and CT have higher sensitivities to liver and intrapancreatic lesions, but have lower detection rates for smaller lesions in the duodenum and lymph nodes. Angiography and percutaneous transhepatic venous gastroscopy may be further used for this purpose. Determination of Susceptibility, Radionuclide Imaging, etc. Of the 17 cases, 16 were treated 38 times. Multiple operations accounted for 56%. Total gastrectomy was performed in 7 patients (7/17,41%). The average follow-up of 15 patients was 6 years and 5 months, and the 5-year survival rate was 87% (13/15). Conclusion Improving the early diagnosis of the disease, fighting for tumor resection and reducing liver metastasis are the key to improve the prognosis.