Somatostatinoma

　　Regarding the pathogenic factors of somatostatinoma, it can be said that they are not yet clear at present. However, with the progress of research, some tendency opinions have been formed, such as the proportion of somatostatinoma in patients with chronic pancreatitis and diabetes is higher than that in the normal population. However, the relationship between diabetes and somatostatinoma, cause and effect, is still controversial. Because indeed, some patients with somatostatinoma present with diabetes in the early stage.

　　1、Weight loss:The weight loss caused by somatostatinoma is the most prominent, with significant weight loss occurring in the short term after onset, weight loss can reach3Over 0 pounds, accompanied by weakness and fatigue.

　　2、Symptomatic diabetes:A few patients may initially present with symptoms of diabetes. Therefore, if diabetic patients experience persistent abdominal pain, or elderly patients suddenly develop diabetes, or if previously diagnosed diabetes suddenly worsens, the possibility of pancreatic cancer should be considered.

　　3、Thrombophlebitis:Patients with somatostatinoma may experience migratory thrombophlebitis or arterial thrombosis.

　　4、Psychological symptoms:Some patients with somatostatinoma may exhibit symptoms such as anxiety, impatience, depression, and personality changes.

　　5、Other:Some patients have hyperparathyroidism and a family history. Some patients develop erythema and pruritus.

　　1、The clinical diagnosis of this disease is relatively difficult, as the clinical symptoms of somatostatinoma are rare and therefore not easily detected; especially other functional endocrine tumors can also secrete small amounts of somatostatin and cause corresponding symptoms, which are easy to confuse with this disease. When patients have the above clinical manifestations and serum somatostatin levels are significantly elevated, the possibility of this disease should be suspected.

　　2、The determination of plasma somatostatin levels by radioimmunoassay. If the baseline PP level is normal, a protein meal or secretin can be used for provocative testing. A significant increase in PP is also helpful in diagnosing the disease.

　　3、B-ultrasonography, CT, MRI, and selective abdominal aortic angiography, etc., are helpful in understanding the location, number, and presence of metastases of the tumor, but cannot be used for definitive diagnosis. Intraoperative ultrasound examination can help identify occult lesions with small tumors and deep locations. The determination of hormones in the tumor by immunohistochemical methods shows a significant increase in somatostatin content in the tumor tissue, while other pancreatic endocrine hormones are rare or absent, which is one of the important bases for the disease.

　　4、Fedorak报道采用经皮肝穿刺门静脉系统置管取血（PTPC）与选择性动脉注射美蓝（SAMBI）结合使用，有助于本病的定性和定位诊断。

　　本病病因不清，难以预防，但随着各项研究发现可以对肿瘤发生的一些相关因素在发病前进行预防。很多肿瘤在它们形成以前是能够预防的。1988年美国的一份报告详细比较了国际上恶性肿瘤相关情况，提出许多已知的恶性肿瘤其外部因素原则上是可以预防的，即大约80％的恶性肿瘤是可以通过简单的生活方式改变而预防。继续追溯，1969年Higginson医生所作的研究总结出90％的恶性肿瘤是由环境因素造成的。“环境因素”、“生活方式”即是指呼吸的空气、喝的水、选择制作的食品、活动的习惯和社会关系等。

　　1、放射免疫法测定血浆胰多肽水平，本病病人早晨空腹PP水平显著升高，多为正常的20～50倍，有的甚至高达700倍以上，如果基础PP水平正常，可用蛋白餐或胰泌素作激发试验，PP显著增高者，也有助于诊断本病。

　　2、B超，CT，MRI，术中超声检查和选择性腹腔动脉造影等检查。

　　3、经皮肝穿刺门静脉系统置管取血(PTPC)与选择性动脉注射美蓝(SAMBI)检查，作者介绍1Example.72Xronia, o agios andrias, me kathgoria douleias, CT synagermatos gia onoma tou karkinomatos tou telos tou pankreatos, i angiografia eikona ena karkinoma tou telos tou pankreatos.2cm mikrwn tou karkinomatos, i serika eugunh metra tos kai to polyptide einai epanthrommena, kai auto einai ena kai gia tin eugunh kai gia tin eugunh, kai meta tis eugunhs, ginetai perissotero.10％glukoxalikos kalcios.5ml, ena ena kai meta tin eugunh,30,60,90,120,180 deiktes, apo to xefaliko tou kefalou, xeretai to glukagon tou kai to polyptide, kai to polyptide einai perissotero tis omologou.500% kai to level tou glukagonou einai autono meta tis eugunias kai kai meta tis eugunias, ston xirourgikon, otan teleietai h eugunh, apotithetai apo to splagchniko xefaliko.2Ml sterilismenon melas, i splagchna kai i telei tou pankreatos synisth kai kanei kyanh.2Metra pos, eksei men kai to telos tou karkinomatos tou pankreatos.2Kamatosi kseroides, kai ta alla merhmata den einai apokleisth, xekinei distal pancreatektomh, i onoma tou karkinomatos einai pleta polyptideon.

　　1、胰腺癌手术后吃哪些食物对身体好

　　饮食首先要选择富含营养，易消化，少刺激性、低脂肪的饮食，可给高蛋白，多碳水化合物的食物，如奶类、鱼肉、肝、蛋清、精细面粉食品、藕粉、果汁、菜汤、粳米等。并配合具有软坚散结，疏肝理气的食物，如山楂、麦芽、苡仁米、神曲、赤豆、荠菜、麦冬、木香、瓜蒌、当归、黄芪、党参、银花、海带、海藻、紫菜等。应常用补益气血、健脾和胃之晶，如糯米、赤豆、蚕豆、山药、枸杞、淡菜、无花果、榛子、牛奶、菱角粉等。

　　2、胰腺癌手术后最好不要吃哪些食物

　　要避免暴饮、暴食、酗酒和高脂肪的饮食。要少吃或限制食肥肉、鱼子、脑髓、油腻、煎炸等不易消化的食品，忌食葱、姜、蒜、辣椒等辛辣刺激品，忌烟酒。

　　一、手术治疗

　　外科手术是本病的首选治疗方法，尤其是对于早期、孤立性的肿瘤，应争取手术切除。

　　1、位于胰体、尾部的肿瘤，呈孤立性的表浅病灶，可行肿瘤剜除术；位置深在，或呈多发性者，则行胰体、尾部切除术。

　　2、胰头部肿瘤，可行80％的胰切除加肿瘤切除；如果瘤体较大，单纯胰腺切除较困难者，亦可行胰十二指肠切除术。

　　3、对于肿瘤体积大，病程较晚或已有转移的病人，行肿瘤减容术也能起到缓解作用。

　　二、化学疗法

　　对于晚期肿瘤病人，可行化学治疗，药物以链脲霉素（streptozotocin）为首选。有人应用链脲霉素治疗2Παρουσία ασθενών με όγκο της πυκνότητας της πυκνότητας, από τους οποίους1Παρουσία3Η οκρετοτιδίνη αιθανάτη μπορεί να αναστέλλει ευρέως την παραγωγή της πυκνότητας από τις λειτουργικές ενδοκρινικές όγκους, η αποτελεσματικότητα μπορεί να φτάσει στο90％. Η χημειοθεραπεία μπορεί να ανακουφίσει ή να ανακουφίσει μέρος των συμπτωμάτων, η πυκνότητα της σειράς της πυκνότητας μπορεί να μειωθεί ακόμη και να επανέλθει στο φυσιολογικό.