Pancreatic polypeptide tumor

Introduction to pancreatic polypeptide Pancreatic polypeptide (PP) is secreted by pancreatic PP cells (or F cells). PP cells are distributed in islet tissue or scattered in the pancreatic exocrine glands. Pancreatic polypeptidoma (PPoma) is a pancreatic secretory PP. The endocrine tumor with increased cells is one of the endocrine tumors of the digestive tract. It mainly occurs in pancreatic endocrine cells containing Pancreatic Polypeptide (PP). It is extremely rare in clinical practice. According to incomplete statistics, there are still less than 20 patients in China. No literature has been reported yet. basic knowledge The proportion of illness: 0.005% Susceptible people: no specific population Mode of infection: non-infectious Complications: erythema pruritus

Pancreatic polypeptide tumor etiology

The pathogenic factors of pancreatic polypeptide tumors can be said to be unclear at present, but as the research progresses, there are still some biased views. For example, the proportion of pancreatic polypeptide tumors in people with chronic pancreatitis and diabetes is higher than normal. The crowd is higher. However, the relationship between diabetes and pancreatic polypeptide tumors is still controversial. Because some patients with pancreatic polypeptide tumors are present in the form of diabetes in the early stage.

Pancreatic polypeptide tumor prevention

The disease is a rare disease, usually pay attention to a healthy diet.

Pancreatic polypeptide tumor complications Complications, erythema

Some patients have hyperparathyroidism and have a family history. Some patients have erythema and itching.

Pancreatic polypeptide tumor symptoms Common symptoms Digestive tract stenosis Abdominal pain Unexplained fever

1. The clinical diagnosis of this disease is difficult, because the clinical symptoms of pancreatic polypeptide tumors are rare, so it is not easy to be found; especially other functional endocrine tumors can sometimes secrete a small amount of pancreatic polypeptide, and cause corresponding symptoms, easy to The disease is confused. When the patient has the above clinical manifestations and the serum pancreatic polypeptide can also be significantly increased, the possibility of the disease should be suspected.

2. The plasma pancreatic polypeptide level is determined by radioimmunoassay. If the basal PP level is normal, the protein meal or secretin can be used as a challenge test. The significant increase in PP is also helpful in diagnosing the disease.

3. B-ultrasound, CT, MRI and selective celiac angiography, etc., can help to understand the location, number of tumors and the presence or absence of metastases, but can not be used for qualitative diagnosis. Intraoperative ultrasound can help to find small tumors and locations. In deep occult lesions, immunohistochemistry was used to determine the hormones in the tumor. It can be seen that the content of pancreatic polypeptide in tumor tissues is significantly increased, and other pancreatic endocrine hormones are rare or absent, which is one of the important basis of this disease.

4. Fedorak reported that the use of percutaneous transhepatic portal vein catheterization (PTPC) combined with selective arterial injection of methylene blue (SAMBI) is helpful for the qualitative and local diagnosis of this disease.

Examination of pancreatic polypeptide tumors

1. Radioimmunoassay for plasma pancreatic polypeptide levels, the patient's fasting PP level increased significantly in the morning, mostly 20 to 50 times normal, and some even up to 700 times. If the basic PP level is normal, protein meal or pancreas can be used. The prostaglandin challenge test, a significant increase in PP, is also helpful in diagnosing the disease.

2. B-ultrasound, CT, MRI, intraoperative ultrasonography and selective celiac angiography.

3. Percutaneous transhepatic portal vein catheterization (PTPC) and selective arterial injection of SAMBI. The authors introduced a 72-year-old male patient who complained of abdominal pain and CT showed pancreatic tail space. In the lesion, angiography showed a 2cm tumor smear staining in the tail of the pancreas. The results of serum radioimmunoassay showed elevated glucagon and pancreatic polypeptide. Therefore, the patient was treated with percutaneous hepatic venous catheter and selective spleen. The artery was placed in the tube, and 5 ml of 10% calcium gluconate was injected from the splenic artery. Blood was taken from the hepatic vein before injection and 30, 60, 90, 120, and 180 seconds after the injection, and glucagon was measured. As a result, the content of pancreatic polypeptide increased by 500% compared with the baseline value, while the level of glucagon remained unchanged after the injection of calcium. At the time of surgery, after the end of the exploration, 2 ml of sterilization was injected from the splenic artery cannula. After the blue, the spleen and the tail of the pancreas were immediately stained blue; after 2 minutes, except for the 2 cm large nodules in the tail of the pancreas, the remaining parts were blue, and the distal pancreatectomy was performed. ), tumor tissue is immunized A histological examination confirmed the presence of abundant pancreatic polypeptide.

Diagnosis and differentiation of pancreatic polypeptide tumor

Different from other tumors that occur in the pancreas.

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