Tshuaj insulinoma

Qhov tshuaj insulinoma yog lub qog ntshav hauv lub txiav ntshav uas tsim tawm cov tshuaj insulin ntau dhau.

Qhov txiav ua ke yog cov khoom hauv plab. Lub txiav ua rau ntau lub enzymes thiab cov tshuaj hormones, suav nrog cov tshuaj insulin. Insulin txoj haujlwm yog txhawm rau txo cov ntshav qabzib hauv cov ntshav los ntawm kev pab cov piam thaj txav mus rau hauv cov ntshav.

Feem ntau thaum koj cov ntshav qab zib hauv lub cev txo qis, tus txiav yuav tsis ua rau cov insulin kom paub tseeb tias koj cov piam thaj hauv ntshav nyob hauv lub cev ib txwm nyob. Cov qog ntawm lub txiav uas tsim insulin ntau dhau lawm yog hu ua insulinomas. Cov tshuaj Insulinomas ua rau insulin, thiab tuaj yeem ua rau koj cov ntshav qab zib kom qis dhau (ntshav qog ntshav qab zib tsawg).

Cov qe ntshav hauv ntshav siab ua rau cov ntshav qab zib kom ntshav qis (ntshav qog ntshav qab zib). Kev muaj ntshav qab zib tsawg yuav ua rau me, ua rau cov tsos mob xws li kev ntxhov siab thiab kev tshaib plab. Lossis nws tuaj yeem ua mob hnyav, ua rau qaug dab peg, tsis nco qab, thiab tuag taus.

Cov tshuaj Insulinomas yog cov hlav qog tsawg. Lawv feem ntau tshwm sim ua ib leeg, hlav me me. Tab sis kuj tseem tuaj yeem muaj ntau lub qog hlav.

Cov tshuaj insulinomas feem ntau tsis mob qog nqaij hlav (tsis zoo). Cov neeg muaj qee yam mob caj ces, xws li ntau yam kab mob endocrine neoplasia hom I, yog qhov pheej hmoo ntau dua rau insulinomas.

Cov tsos mob tshwm sim feem ntau yog thaum koj yoo mov lossis hla los yog ncua pluas noj. Cov tsos mob tuaj yeem suav nrog:

• Kev ntxhov siab, kev hloov pauv tus yam ntxwv, lossis kev ntxhov siab
• Cloud tsis pom kev
• Plam nco qab lossis tsis nco qab lawm
• Qhov pomzoo lossis tshee tshee
• Kiv taub hau lossis mob taub hau
• Tshaib plab ntawm cov mov noj; nce phaus yog ib yam
• Lub plawv dhia ceev ceev lossis palpitations
• Tawm hws

Tom qab yoo mov, koj cov ntshav yuav raug ntsuas rau:

• Ntshav C-peptide theem
• Ntshav qabzib nyob theem
• Ntshav cov ntshav insulin theem
• Cov tshuaj uas ua rau txiav lub txiav me me tawm ntawm cov insulin
• Cov lus teb hauv koj lub cev tau txhaj tshuaj ntawm glucagon
  

CT, MRI, lossis PET scan ntawm lub plab zom mov tuaj yeem kho tus mob qog ntshav rau ntawm lub txiav. Yog tias qog tsis pom nyob rau hauv kev soj, ib qho kev sim hauv qab no tuaj yeem ua:

• Endoscopic ultrasound (kuaj uas siv lub zog hloov tau yooj yim thiab lub suab tsis zoo los saib cov plab hnyuv plab zom mov)
• Kev ntsuas Octreotide (kuaj tshwj xeeb uas ntsuas cov qe tsim tshwj xeeb hauv lub cev)
• Pancreatic arteriography (kuaj uas siv cov xim tshwj xeeb los saib cov hlab ntsha hauv lub txiav)
• Pancreatic venous sampling rau cov tshuaj insulin (kuaj ntsuas uas pab pom qhov chaw ze ntawm lub qog nqaij hlav hauv lub txiav)

Kev phais mob yog kev kho mob ib txwm siv rau insulinoma. Yog tias muaj cov qog hlav xwb, nws yuav raug tshem tawm. Yog tias muaj ntau cov qog nqaij hlav, ib feem ntawm txoj kev ua tiav txiav yuav tsum tau tshem tawm. Tsawg kawg 15% ntawm tus txiav yuav tsum nyob sab hauv los tsim cov qib ntawm cov enzymes rau kev zom zaub mov.

Tsawg tsawg zaus, tag nrho cov txiav tawm raug tshem tawm yog tias muaj ntau yam tshuaj insulinomas lossis lawv tseem rov qab los. Tshem tag nrho cov txiav ua rau mob ntshav qab zib vim tias tsis muaj ib yam tshuaj insulin ntxiv lawm. Tom qab ntawv txhaj tshuaj insulin (kev txhaj tshuaj) ntxiv.

Yog tias tsis muaj cov qog ntshav tshawb pom thaum phais mob, lossis yog tias koj tsis tuaj yeem phais, koj tuaj yeem txais cov tshuaj diazoxide kom txo qis cov kua dej thiab tiv thaiv kev mob ntshav qab zib. Cov dej tshuaj (diuretic) tau muab nrog cov tshuaj no tiv thaiv lub cev kom tsis txhob ntim dej. Octreotide yog lwm yam tshuaj uas siv los txo cov tshuaj insulin tawm hauv qee tus neeg.

Feem ntau, lub qog tsis mob-qog nqaij (benign), thiab phais yuav kho tus mob. Tab sis ib qho kab mob ntshav nce siab ntau dhau los sis kev kis mob qog mus rau lwm qhov hauv nrog cev tuaj yeem cuam tshuam lub neej tau.

Teeb meem yuav suav nrog:

• Cov tshuaj tiv thaiv kev qog ntshav siab hnyav
• Kis ntawm tus mob qog nqaij hlav (metastasis)
• Mob ntshav qab zib yog tias tag nrho cov txiav ua ntshav tshem tawm (tsis tshua muaj), lossis zaub mov tsis tau nqus yog tias ntau dhau ntawm lub txiav txiav
• O kev mob thiab o ntawm lub txiav

Hu rau koj tus kws kho mob yog tias koj muaj cov tsos mob ntawm insulinoma. Qhov qaug dab peg thiab tsis nco qab yog qhov xwm ceev. Hu rau 911 lossis tus npawb xov tooj xwm ceev hauv zos tam sim.

Insulinoma; Islet cell adenoma, nqaij hlav Pancreatic neuroendocrine; Kev Hypoglycemia - insulinoma

• Cov qog endocrine
• Khoom noj khoom haus thiab insulin tso

Asban A, Patel AJ, Reddy S, Wang T, Balentine CJ, Chen H. Cancer ntawm endocrine system. Hauv: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical OncologyCov. 6 tus ed. Philadelphia, PA: Elsevier; 2020: chap 68.

Lub Tebchaws National Comprehensive Cancer Network lub vev xaib. NCCN cov chaw kuaj mob hauv cov kev qhia txog oncology (Cov txheej txheem NCCN): Neuroendocrine thiab qog adrenal. Daim Ntawv 2.2020. www.nccn.org/professionals/physician_gls/pdf/neuroendocrine.pdf. Hloov kho Lub Xya Hli 24, 2020. Nkag mus Lub Kaum Ib Hlis 11, 2020.

Strosberg JR, Al-Toubah T. Neuroendocrine hlav. Hauv: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger thiab Fordtran's Gastrointestinal thiab Kab Mob SiabCov. 11th ed. Philadelphia, PA: Elsevier; 2021: chap 34.