Mulkeen Abby, Cha Charles
Department of Surgery, Yale University School of Medicine, New Haven, CT 06520-8062, USA.
Curr Opin Oncol. 2005 Jan;17(1):1-6. doi: 10.1097/01.cco.0000147899.04701.c6.
Gastric carcinoid tumors are rare lesions but have been the focus of much scientific investigation. The incidence of gastric carcinoid appears to be increasing without a corresponding increase in survival, despite utilization of the latest available therapies. Therefore, there is great interest in furthering the understanding of the biologic basis of these tumors, delineating the connection between hypergastrinemia and gastric carcinoids, and most importantly, improving upon current treatment options.
This review discusses the current biologic understanding of gastric carcinoid tumors, including the role of hypergastrinemia on enterochromaffin-like cell proliferation and its relation to acid-suppressive therapy. Numerous diagnostic and therapeutic modalities including endoscopic ultrasound, somatostatin receptor scintigraphy, long-acting octreotide, hepatic artery embolization, endoscopic mucosal resection, and surgical resection have also been the focus of recent investigations.
Despite the many advances that have been made in both the basic science and clinical arenas, the optimal treatment of gastric carcinoid tumors is still a matter of debate. As the understanding of the biologic basis of gastric carcinoid tumors increases, the treatment will likely be a multimodal approach tailored to individual tumor biology and will incorporate a variety of diagnostic and therapeutic modalities.
胃类癌肿瘤是罕见病变,但一直是众多科学研究的焦点。尽管采用了最新的可用疗法,但胃类癌的发病率似乎在上升,而生存率却没有相应提高。因此,人们对进一步了解这些肿瘤的生物学基础、阐明高胃泌素血症与胃类癌之间的联系,以及最重要的是改进当前的治疗方案有着浓厚兴趣。
本综述讨论了目前对胃类癌肿瘤的生物学认识,包括高胃泌素血症在肠嗜铬样细胞增殖中的作用及其与抑酸治疗的关系。包括内镜超声、生长抑素受体闪烁显像、长效奥曲肽、肝动脉栓塞、内镜黏膜切除术和手术切除在内的多种诊断和治疗方式也是近期研究的重点。
尽管在基础科学和临床领域都取得了许多进展,但胃类癌肿瘤的最佳治疗方法仍存在争议。随着对胃类癌肿瘤生物学基础的认识不断增加,治疗可能会是一种根据个体肿瘤生物学特性量身定制的多模式方法,并将纳入多种诊断和治疗方式。