Scherübl H, Faiss S, Jahn H U, Liehr R-M, Schwertner C, Steinberg J, Stölzel U, Weinke T, Zimmer T, Klöppel G
Klinik für Gastroenterologie und GI Onkologie, Vivantes Klinikum Am Urban, Berlin.
Dtsch Med Wochenschr. 2009 Jul;134(30):1529-35. doi: 10.1055/s-0029-1233975. Epub 2009 Jul 14.
Neuroendocrine tumors (NET) of the stomach are on the rise. In the United States they have increased about tenfold in the last 35 years. Prognosis has been much improved over the last three to four decades. Nowadays most of such NETs are diagnosed at an early stage. Quite often gastric NETs are found incidentally during a gastroscopy, performed for other reasons. Most of the asymptomatic, well differentiated gastric NETs are less than 2 cm in diameter. Conservative management and endoscopic surveillance is adequate for well differentiated, multifocal type 1 or type 2 gastric NETs (gastric carcinoids) of 10-20 mm , unless they are angio-invasive, have infiltrated into the muscularis propria or have metastasized. Endoscopic ultrasound is the method of choice to determine tumor size and depth of infiltration. Surgery is, however, indicated for all NETs larger than 20 mm. For optimal management tumor biology, type and stage of the neoplasm as well as the individual situation of the patient have to be taken into account. Most of the patients can be treated conservatively and be followed up with endoscopic surveillance.
胃神经内分泌肿瘤（NET）的发病率正在上升。在美国，过去35年中其发病率增加了约10倍。在过去的三到四十年里，预后有了很大改善。如今，大多数此类NET在早期被诊断出来。胃NET常常在因其他原因进行的胃镜检查中偶然发现。大多数无症状、分化良好的胃NET直径小于2厘米。对于直径10 - 20毫米、分化良好的多灶性1型或2型胃NET（胃类癌），除非它们具有血管浸润、浸润至固有肌层或已发生转移，否则保守治疗和内镜监测就足够了。内镜超声是确定肿瘤大小和浸润深度的首选方法。然而，所有直径大于20毫米的NET都需要手术治疗。为了实现最佳治疗，必须考虑肿瘤生物学特性、肿瘤类型和分期以及患者的个体情况。大多数患者可以接受保守治疗并通过内镜监测进行随访。
