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胰外肿瘤引起低血糖,一般认为可能为异位胰岛素所致。1976年Vaitukaitis对异位激素的诊断提出5条标准。作者在复习了120例伴有低血糖的胰外肿瘤病例(这些病例在低血糖时都作过胰岛素或胰岛素样活性测定),对照Vaitukaitis标准,对肿瘤产生异位胰岛素提出疑问。因在上述120例病人中没有1例具备5条标准中2条以上。故认为胰外肿瘤出现低血糖的原因不能证明是由于胰岛素。因除了极少数病例血胰岛素增高外,一般都不高。且在增高的病例中也不能除外胰岛β-细胞分泌增强的因素。作者也注意到有些血胰岛素高的病例有类癌的组织学改变。在某些梭状细胞肿瘤和类癌肿瘤两者间密切相关,而这种类癌肿瘤等又涉及间皮瘤起源的问题,这方面值得进一步研究。
Pancreatic tumors cause hypoglycemia, is generally believed that may be caused by ectopic insulin. In 1976 Vaitukaitis proposed five criteria for the diagnosis of ectopic hormones. After reviewing 120 cases of extra-pancreatic neoplasms associated with hypoglycaemia (all of which were insulin or insulin-like activity in hypoglycemia), the authors questioned the tumor’s production of ectopic insulin against the Vaitukaitis criteria. Because none of the 120 patients listed above had two or more of the five criteria. Therefore, the cause of hypoglycemia in pancreatic tumors can not be proved due to insulin. Except for a very small number of cases of blood insulin, generally not high. In addition, elevated pancreatic islet β-cell secretion can not be excluded. The authors also note that some hyperinsulinemic cases have histological changes of carcinoids. In some spindle cell tumors and carcinoid tumors are closely related between the two, and this type of cancer tumors and other issues related to the origin of mesothelioma, which deserves further study.