Schnirer Isac I, Yao James C, Ajani Jaffer A
Department of Gastrointestinal Oncology and Digestive Diseases, The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77005-4341, USA.
Acta Oncol. 2003;42(7):672-92. doi: 10.1080/02841860310010547.
Carcinoid tumors originate from the neuroendocrine cells throughout the body and are capable of producing various peptides. Their clinical course is often indolent but can also be aggressive and resistant to therapy. We examined all aspects of carcinoid tumors including the molecular biology oncogenesis, role of angiogenesis, recent advances in imaging, and therapy. The Medline and Cancerlit databases were searched using carcinoid as the keyword. English language manuscripts were reviewed and relevant references from a total of 7741 were found. All titles were screened and all the relevant manuscripts were analyzed; we found 307 references pertinent to the history, epidemiology, clinical behavior, pathology, pathophysiology, molecular biology, radiologic imaging, supportive care of carcinoid syndrome, and results of therapeutic clinical trials. Management of patients with carcinoid tumors requires an understanding of the disease process and a multimodality approach. Introduction of long-acting somatostatin analogues has resulted in significant advances in the palliative care of patients with carcinoid syndrome. However, advanced carcinoid tumor remains incurable. Existing therapies for advanced disease have low biologic activity, high toxicity, or both. Clearly, more research is necessary in the areas of molecular biology, targeted therapy, and development of new drugs Future advances in this field need to focus on clinical and biological predictors of outcome. Early works in the area of tumor biology such as the role of p53, bcl-2, bax, MEN1, FGF TGF PDGF and VEGF expression are of interest and need to be explored further.
类癌肿瘤起源于全身的神经内分泌细胞，能够产生多种肽类。其临床病程通常较为隐匿，但也可能具有侵袭性且对治疗耐药。我们研究了类癌肿瘤的各个方面，包括分子生物学致癌机制、血管生成的作用、影像学的最新进展以及治疗方法。以“类癌”为关键词检索了Medline和Cancerlit数据库。对英文手稿进行了综述，共找到7741篇相关参考文献。对所有标题进行了筛选，并对所有相关手稿进行了分析；我们发现307篇参考文献与类癌肿瘤的病史、流行病学、临床行为、病理学、病理生理学、分子生物学、放射影像学、类癌综合征的支持治疗以及治疗性临床试验结果相关。类癌肿瘤患者的管理需要了解疾病过程并采用多模式方法。长效生长抑素类似物的引入在类癌综合征患者的姑息治疗方面取得了显著进展。然而，晚期类癌肿瘤仍然无法治愈。现有针对晚期疾病的疗法生物活性低、毒性高或两者兼具。显然，在分子生物学、靶向治疗和新药研发领域需要更多的研究。该领域未来的进展需要关注预后的临床和生物学预测指标。肿瘤生物学领域的早期研究，如p53、bcl-2、bax、MEN1、FGF、TGF、PDGF和VEGF表达的作用，很有意思，需要进一步探索。
