Strosberg Jonathan R, Nasir Aejaz, Hodul Pamela, Kvols Larry
Department of GI Oncology, H. Lee, Moffitt Cancer Center, Tampa, FL.
Gastrointest Cancer Res. 2008 May;2(3):113-25.
Neuroendocrine malignancies of the gastroenteropancreatic axis include carcinoid and pancreatic endocrine tumors. These heterogeneous neoplasms arise from the enterochromaffin cells of the gastrointestinal tract and the islet cells of the pancreas. Histologically, most well-differentiated endocrine tumors consist of small, round, monomorphic cells, arranged in islands or trabeculae, with a distinct "salt-and-pepper" pattern of nuclear chromatin. Chromogranin and synaptophysin are useful as immunohistochemical markers of neuroendocrine differentiation. Other common features include the capacity to secrete peptide hormones and biogenic amines. A relatively indolent growth rate is characteristic of most gastrointestinal neuroendocrine tumors, with the exception of poorly differentiated tumors which are usually aggressive. Treatment strategies are designed to limit tumor progression and palliate hormonal syndromes. This article reviews the diverse biologic characteristics of gastrointestinal neuroendocrine tumors and current treatment options for metastatic disease.
胃肠胰神经内分泌恶性肿瘤包括类癌和胰腺内分泌肿瘤。这些异质性肿瘤起源于胃肠道的肠嗜铬细胞和胰腺的胰岛细胞。组织学上，大多数高分化内分泌肿瘤由小的、圆形的、单形性细胞组成，排列成岛状或小梁状，具有独特的核染色质“椒盐”样模式。嗜铬粒蛋白和突触素可用作神经内分泌分化的免疫组化标志物。其他共同特征包括分泌肽类激素和生物胺的能力。大多数胃肠神经内分泌肿瘤生长相对缓慢，分化差的肿瘤通常具有侵袭性，属于例外情况。治疗策略旨在限制肿瘤进展并缓解激素综合征。本文综述了胃肠神经内分泌肿瘤的多种生物学特性以及转移性疾病的当前治疗选择。
