摘要目的 探讨胰高血糖素瘤的临床诊治方法.方法 回顾性分析1993年6月至2008年7月北京协和医院收治的11例胰高血糖素瘤患者的临床资料,其中男性5例,女性6例,年龄38～61岁,平均49.6岁.按发病性别、年龄、误诊情况、临床表现、实验室检查、影像学检查、诊断、治疗方法等项目进行分析.结果 11例肿瘤均位于胰体尾部,其中单发10例,合并胰头部肿物l例,平均大小3.9 cm(2.5～6.3 cm);9例发生肝转移;1例无胰外转移,但镜下可见其侵犯胰腺被膜且有淋巴结转移(胰周1/5);1例合并MEN-1.8例行手术治疗的患者均有详细病理报告,5例行免疫组织化学胰高血糖素项检查,除1例合并MEN-1患者的多发胰腺占位中胰头区胰高血糖素阴性,余结果均为阳性;6例病理证实为恶性.所有患者均接受包括手术、动脉介入栓塞化疗、生长抑素或核素等多模式治疗.结论 胰高血糖素瘤是罕见疾病,手术是首选的治疗方法,应用多模式治疗策略叮望改善预后.

abstractsObjective To study the diagnosis and treatment of glucagonoma. Methods A retrospective review of glueagonoma eases was committed between June 1993 and July 2008 in Peking Union Medical College Hospital. It was measured by sex, age, misdiagnosis, clinical symptoms, laboratory data, imaging studies, diagnosis, treatment procedures and so on. Results The tumors of eleven cases were found in the tail, and one case was in the head of the pancreas at the same time. Ten had solitary lesion, one had multiple lesions. The average diameter of the lesions was 3.9 era. Nine patients had the metastasis out of pancreas and all of them had the liver metastasis. One case was a member of multiple endocrine neoplasia type 1 (MEN-1) syndromes. Eight patients being treated with operation had the detailed pathological reports. The glucagon was detected by immunohistochemistry and was positive in five patients. Six patients were pathologically malignant. Multimodal treatments included tumor resection, chemoembolisation, therapied with somatestafin analogues and(or) radionuchdes and so on were applied to all patients. Conclusions Glucagonoma is a rare pancreatic endocrine tumor. Radical tumor surgery is used as the first choice. Multimedal approach may improve the prognosis.