关键词: 胰岛素瘤, 糖耐量试验, 同步胰岛素释放试验, 诊疗

Abstract: Objective To analyze the clinical characteristics of insulinoma and evaluate the methods used in the diagnosis and treatment of insulinoma. Methods The clinical data of 18 patients with insulinoma were retrospectively analyzed from January 2008 to December 2015, which were combined with the domestic and foreign related literature for analysis and summary of diagnosis and treatment. Results All the 18 cases had Whipple triad syndrome. Unconsciousness was the most common syndrome due to hypoglycemia (15/18). Five of the patients were misdiagnosed. Fourteen cases had glucose tolerance- insulin release test, and 12 of them had hypoglycemia (blood glucose was below 2.78 mmol/L). Eight patients had a insulin/glucose ratio ＞0.4 in three hours, and 12 patients in 5 hours. Tumor was detected by several imaging techniques in different patients. The sensitivity rate for B ultrasound was 6/15, for plain CT was 1/6, for contract CT was 11/ 13, for perfusion CT was 2/3, for MRI was 10/12, for contract MRI was 5/5, for endoscopic ultrasonography was 1/1, for digital subtraction angiography (DSA) was 1/2, and for intraoperative ultrasonography (IOUS) was 2/2. All 18 patients were underwent surgical treatment, and no any patient was found episodes of hypoglycemia after surgery. Conclusion Consciousness is the most common symptom caused by insulinoma. The 5 h glucose-insulin release test is more meaningful than the 3 h test. Multiple inspection methods can be used for the clear localization of the tumors before operation. Surgery is still the most preferred treatment for insulinoma.

Key words: insulinoma, glucose tolerance test, insulin release test, diagnosis and treatment