Pancreatic endocrine tumors

　　Pancreatic endocrine tumors are a type of tumor derived from pancreatic pluripotent neuroendocrine stem cells, which are rare in clinical practice, with complex and diverse symptoms. They can gradually develop from benign to malignant, with a slow course of disease and are prone to be confused with primary endocrine diseases. Clinical doctors have a general lack of understanding of this disease, and misdiagnosis and missed diagnosis are common, which can easily lead to long-term misdiagnosis and mismanagement of patients, even causing serious irreversible damage.Related to smoking, drinking, high-fat and high-protein diet, excessive coffee consumption, environmental pollution, and genetic factors, as well as. They can gradually develop from benign to malignant, with a slow course of disease and are prone to be confused with primary endocrine diseases.

　　The incidence of pancreatic endocrine tumors is continuously rising, and the symptoms are complex and diverse. They can gradually develop from benign to malignant, and generally, this disease can lead to the following complications:

　　1. Pancreatic fistula

　　It is the most common and fatal complication after pancreatic resection. The patient may experience abdominal distension, abdominal pain, high fever, and an increase in abdominal drainage fluid, which can be confirmed as pancreatic fistula.

　　2. Abdominal infection

　　This condition is a serious complication, often caused by pancreatic fistula, biliary fistula, or abdominal hemorrhage combined with infection.

　　Pancreatic neuroendocrine tumors can be divided into 'functional' and 'non-functional' tumors according to whether they cause clinical symptoms. The former has corresponding clinical symptoms due to the production of certain hormones, and can be classified into insulinomas, gastrinomas, glucagonomas, vasoactive intestinal peptide-secreting tumors, somatostatinomas, and others. While 'non-functional' tumors may not produce neuroendocrine substances, they simply do not cause special clinical symptoms. The following are common symptoms of different types of pancreatic endocrine tumors:

　　1. Insulinoma

　　Weakness, profuse sweating, tremors, tachycardia, anxiety, fatigue, headache, dizziness, disorientation, seizure, confusion of consciousness.

　　2. Gastrinoma

　　Persistent or recurrent peptic ulcer (hemorrhage, perforation), complications of peptic ulcer, diarrhea.

　　3. VIPoma

　　Profuse watery diarrhea, flushed complexion, hypotension, abdominal pain.

　　4. Glucagonoma

　　Necrotic migratory erythema, glossitis, stomatitis, cheilitis, diabetes, severe weight loss, diarrhea.

　　5. Somatostatinoma

　　Weight loss, cholelithiasis, diarrhea, multiple neurofibromas.

　　6. Non-functional islet cell tumor

　　Symptoms of tumor compression, obstructive jaundice, pancreatitis, duodenal obstruction.

　　For the prevention of pancreatic endocrine tumors, the most important thing is that everyone should develop good living habits, quit smoking and drinking; do not eat too much salty or spicy food; do not eat overheated, cold, expired, or deteriorated food; maintain a good attitude towards stress, pay attention to the combination of work and rest; do not overwork, strengthen physical exercise; live a regular life, and do not eat contaminated food.

　　Based on the different clinical manifestations caused by different hormones, combined with the corresponding serum hormone level tests, etc., is the first step in diagnosing suspected endocrine tumors, and then proceed to pancreatic imaging examinations for localization, and then make a diagnosis of pancreatic endocrine tumors. For non-functional pancreatic endocrine tumors, they are often diagnosed due to compression symptoms or during physical examination by imaging examination. Pancreatic endocrine tumors often require surgical treatment, and the final pathological type and nature are determined by immunohistochemical staining.

　　There are many localization diagnostic methods for pancreatic endocrine tumors, including ultrasound, CT, magnetic resonance imaging, PET/CT, endoscopic ultrasound, laparoscopic ultrasound, or ultrasound during laparotomy, and angiography, etc.

　　Pancreatic endocrine tumors are a type of tumor derived from pluripotent neural endocrine stem cells in the pancreas, which are rare in clinical practice and have complex and diverse symptoms. They can gradually develop from benign to malignant. In order to help patients recover quickly, the editor recommends the following food therapy recipe for everyone:

　　1. Decoction of Gardenia jasminoides and wolfberry

　　Ingredients: 5-10 grams of Gardenia jasminoides kernels, 6 grams of fresh lotus root (or 10-15 lotus nodes), 30 grams of white mugwort root, 40 grams of wolfberry, and 130 grams of glutinous rice.

　　Preparation method: Put the kernels of Gardenia jasminoides, lotus node, white mugwort root, and wolfberry into a gauze bag, tie it tightly, and boil it in water to make a decoction. Add glutinous rice to the pot, add the decoction and clear water, bring to a boil, and simmer over low heat until it becomes a thin porridge. You can add a proper amount of honey for seasoning, and it is ready to eat.

　　Properties: Clear heat and eliminate dampness, cool blood and stop bleeding, relieve restlessness and thirst.

　　Indications: Used for pancreatic cancer, distension and pain in the ribs, abdominal mass, poor appetite, pale complexion, fatigue, low fever, epistaxis, and hemorrhage.

　　2. Spinach and Tofu Soup

　　Ingredients: 120 grams of Fojiacao, 180 grams of spinach, 200 grams of tofu, 28 grams of clean asparagus, 750 grams of soybean sprout broth, and appropriate seasonings.

　　Preparation Method: Cut the Fojiacao into sections, place in a gauze bag, add an appropriate amount of water, and boil to make the decoction. Heat the wok, add soybean sprout juice, decoction, tofu cubes, asparagus slices, and salt, and bring to a boil. Add spinach and bring to a boil again. Add MSG and cooked peanut oil, and then remove from heat.

　　Effects: Clear heat and benefit the spleen, reduce swelling and detoxify.

　　Indications: Used for pancreatic cancer, abdominal pain, anorexia, and abdominal masses.

　　3. Pork Pancreas and Kelp Soup

　　Ingredients: 1 pork pancreas (about 100 grams), 30 grams of scallops, 20 grams of kelp, 15 grams of肿节风, 3 grams of ginger juice, and appropriate seasonings.

　　Preparation Method: Cut肿节风 into sections, place in a gauze bag, and boil with water to make the decoction. Wash the pork pancreas and blanch in boiling water. Remove the fur from the shucked scallops and soak the kelp in warm water until softened and then wash it. Heat the pot and add peanut oil, stir-fry the pork pancreas slices, add ginger juice, and then add chicken broth, decoction, scallops, kelp, cooking wine, salt, and soy sauce. Boil and then simmer over low heat until thoroughly cooked. Season with MSG and it is ready to serve.

　　Effects: Tonify the spleen and replenish the qi, clear heat and detoxify, soften hardness and disperse nodules.

　　Indications: Used for pancreatic cancer, anorexia, abdominal pain, fever, weight loss, and abdominal masses.

　　According to the location, size, and pathological typing of the tumor, local resection, pancreaticoduodenectomy, pancreatic head resection with preservation of the duodenum, segmental resection of the pancreas, and resection of the body and tail of the pancreas can be performed. Before surgery, blood sugar, acid suppression, correction of water and electrolyte imbalance, and acid-base balance disorders should be controlled according to different hormone secretion characteristics. Adjuvant somatostatin and its analogs are used for treatment after surgery. Common chemotherapy drugs include streptozotocin, fluorouracil, and doxorubicin, etc. For malignant cases with recurrence after surgery, if resection is possible, reoperation should be performed again. For patients with malignant pancreatic endocrine tumors accompanied by liver metastasis that cannot be resected radically, resection of the tumor mass, gastrointestinal bypass surgery, chemotherapy, hepatic artery embolization treatment, radiofrequency ablation thermal coagulation treatment or cryotherapy under the guidance of B-ultrasound or CT for liver metastases, and other measures can be taken. For cases with localized primary lesions and extensive liver metastases and good general condition, primary lesion resection and combined liver transplantation can be considered after strict selection.