胃肠胰神经内分泌肿瘤的诊断与治疗

Diagnosis and treatment of gastroenteropancreatic neuroendocrine neoplasms

  • 摘要: 胃肠胰神经内分泌肿瘤(GEPNENs)是一种罕见肿瘤,近年来发病率不断增加。神经内分泌肿瘤(NENs) 的诊断依据包括提示NENs的临床表现、生化标志物、基因检测、影像学检查、组织学诊断等。GEPNENs按临床表现可分为功能性和非功能性GEPNENs。手术是局限期GEPNENs的主要治疗手段。然而,大多数GEPNENs患者确诊时已发生远处转移,难以接受根治性手术,最合适的治疗模式是多学科综合治疗,包括手术、化疗、生物治疗、分子靶向治疗以及肽受体放射性核素治疗。分子靶向治疗有望成为标准的一线治疗方案。

     

    Abstract: Gastroenteropancreatic neuroendocrine neoplasms (GEP NENs) are exceedingly rare tumor, with an increasing incidence in recent years. According to the NANETS consensus guidelines for the diagnosis of neuroendocrine tumor, the algorithm for diagnosis of GEP NENs includes clinical syndrome suggestive of NENs, biochemical testing, genetic testing, tumor localization by imaging and tissue diagnosis. GEP NENs could be divided into functional versus non functional based on the clinical manifestations. Radical surgery is the standard first line therapy for limited stage tumors. However, two thirds of GEP NENs patients are inoperable for tumor metastasis at initial diagnosis. For these advance staged patients, multidisciplinary treatment is the best choice, which includes surgery, chemotherapy, biotherapy, molecular targeted therapy, somatostatin receptor targeted radionuclide therapy. Molecular targeted therapy may turn into a standard first line therapy for its good curative effect in recent studies.

     

/

返回文章
返回