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Objective To investigate the clinical,pathologic and endoscopic ultrasound characteristics of pancreatic neuroendocrine tumors (PNETs).Methods Clinical data of 24 consecutive patients of PNETs who were admitted between January 2002 and January 2011 were reviewed.Results Among these 24 patients,19 were diagnosed to have insulinomas,1 was malignant insulinoma,2 were gastrinomas,and 2 were glucagonomas.Eighteen (75％) cases of PNETs were functional PNETs,and 6 (25％) were nonfunctional PNETs.The mean age of the patients was (42 ± 14) years old ranging from 19 ～ 64 years old,and the percentage of male patient was 33.3％.The main symptoms of insulinomas were intermittent abdominal pain or discomfort,and the main manifestations of glucagonomas were weight loss,skin migratory erythema; and the main symptoms of gastrinomas were diarrhea,vomiting with large amounts of water-like liquid.The detection rate of CT was 86.7％ (13/15),and the detection rate of EUS was 100％ (15/15),but PET-CT detected only 40％ of tumors (2/5).The endoscopic ultrasound characteristics of PNETs were circular or oval hypoechoic mass,and the volume was small with clear boundary and homogeneous echo.There was no enlarged lymph node,and liquid was detected in big tumor.Twenty-two patients received operation and 2 patients did not.PNETs expressed CgA and Syn protein.All patients of PNETs were alive with 7 to 80 months follow-up.Conclusions The clinical characteristics of PNETs were unique.EUS has a high accuracy for detecting and localizing PNETs.The surgical method is similar to that of pancreatic cancer,and the prognosis is relatively good.
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Objective To study the efficacy of intra-tumoral injection of different concentrations of ethanol for nude mice with implanted pancreatic cancer and provide evidence for choosing appropriate concentration of ethanol for clinical treatment of pancreatic cancer.Methods A subcutaneous xenograft mouse model of human pancreatic cancer SW1990 was established.Forty-eight nude mice with similar tumor size were randomly divided into 20％,40％,60％,80％,95％ ethanol injection groups and saline injection group.The longest (a) and the shortest diameters (b) of tumor of nude mice were measured.Tumor volume (TV),relative tumor volume (RTV) and the relative rate of tumor proliferation (T/C％) were calculated.Eight days later the nude mice were sacrificed.The tumor tissue was harvested for pathologic examinations.Results RTV in 20％ ethanol injection group was similar that of saline injection group (P =0.212).RTV in 40％,60％,80％ and 95％ ethanol injection groups were significantly lower than that in saline injection group (P ＜ 0.01).RTV was less than 1 and T/C％ was less than 30％ in 60％,80％ and 95％ ethanol injection groups.The values of RTV and T/C％ decreased with the increase of ethanol concentration.RTV in 80％ and 95％ ethanol injection groups were significantly lower than that of 60％ ethanol injection group (P =0.003 and P =0.009).RTV was similar in 80％ and 95％ ethanol injection groups (P =0.819).The pathologic examinations showed no tumor necrosis in saline injection group,while small amounts of necrosis in implanted pancreatic cancer was observed in 20％ and 40％ ethanol injection groups,while a large area of coagulation necrosis could be found in 60％,80％ and 95％ ethanol injection groups.Conclusions Intra-tumoral injection of 80％ ethanol is feasible therapy method for nude mice with human pancreatic cancer xenografts.
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Objective To improve the level of the diagnosis and treatment of gastric ectopic pancreas. Methods We reviewed the data of endoscopic ultrasonography(EUS) examination of gastric submucosal mass from 2000 to 2004 and analyze the EUS features of gastric ectopic pancreas. Results Among 241 cases of gastric submucosal mass, 105 cases were diagnosed as benign stromal tumors, 23 as malignant stromal tumors, 48 as lipomas,45 as ectopic pancreas and 20 as cysts. The EUS features of gastric ectopic pancreas included submucosal lesions (39 cases), clear boundary (37cases),hy-perechoic heterogenous internal echo(42 cases), hypoechoic(3 cases), echoless in the center of the lesions (32 cases). After resection,26 cases confirmed by pathology had no complications. Conclusion EUS examination is helpful to confirm the diagnosis'of gastric ectopic pancreas. Resection under endoscopiy is a an effective measure of treatment.