日本胃肠胰神经内分泌肿瘤的流行病学研究。
Epidemiological study of gastroenteropancreatic neuroendocrine tumors in Japan.
机构信息
Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
出版信息
J Gastroenterol. 2010 Feb;45(2):234-43. doi: 10.1007/s00535-009-0194-8.
BACKGROUND
There have been few epidemiological studies on gastroenteropancreatic neuroendocrine tumors (GEP-NETs) in Japan.
METHODS
We examined the epidemiology of GEP-NETs [pancreatic endocrine tumors (PETs) and gastrointestinal neuroendocrine tumors (GI-NETs)] in Japan in 2005 using a nationwide stratified random sampling method.
RESULTS
A total of 2,845 individuals received treatment for PETs. Prevalence was estimated as 2.23/100,000 with an annual onset incidence of 1.01/100,000. Non-functioning tumor (NF)-PET constituted 47.4%, followed by insulinoma (38.2%) and gastrinoma (7.9%). Distant metastases were reported in 21% patients with NF-PETs and occurred more frequently as tumor size increased (>2 cm). Multiple endocrine neoplasia type 1 (MEN-1) was detected in 10% of PETs but only in 6.1% of NF-PETs. NF-PETs were detected incidentally by physical examination in 24% patients. In 2005, an estimated 4,406 patients received treatment for GI-NETs. Prevalence was estimated as 3.45/100,000, with an annual onset incidence of 2.10/100,000. The locations of GI-NETs varied: foregut, 30.4%; midgut, 9.6%; and hindgut, 60.0%. Distant metastases were observed in 6%. Lymph node metastases occurred more frequently as tumor size increased (>1 cm). The frequency of MEN-1 complications was 1%. Physical examination revealed GI-NETs in 44% patients. The frequency of symptomatic GI-NETs was 3.4%. Interestingly, 77.1% of patients with foregut GI-NETs had type A gastritis.
CONCLUSION
Our results show there are large differences in GEP-NETs between Japan and Western nations, primarily due to differences in the presence of MEN-1 in NF-PETs and the location, symptomatic status, and prevalence of malignancy in GI-NETs.
背景
日本针对胃肠胰神经内分泌肿瘤（GEP-NETs）的流行病学研究较少。
方法
我们采用全国分层随机抽样方法，于 2005 年对日本的 GEP-NETs（胰腺内分泌肿瘤[PETs]和胃肠道神经内分泌肿瘤[GI-NETs]）的流行病学进行了研究。
结果
共有 2845 人因 PETs 接受了治疗。患病率估计为 2.23/100000，年发病发病率为 1.01/100000。无功能性肿瘤（NF）-PET 占 47.4%，其次是胰岛素瘤（38.2%）和胃泌素瘤（7.9%）。21%的 NF-PET 患者出现远处转移，且随着肿瘤大小的增加（>2 cm），转移更为常见。多发性内分泌肿瘤 1 型（MEN-1）在 10%的 PETs 中检出，但仅在 6.1%的 NF-PETs 中检出。NF-PET 中有 24%的患者是通过体检偶然发现的。2005 年，估计有 4406 人因 GI-NETs 接受了治疗。患病率估计为 3.45/100000，年发病发病率为 2.10/100000。GI-NETs 的位置各不相同：前肠，30.4%；中肠，9.6%；后肠，60.0%。有 6%的患者出现远处转移。随着肿瘤大小的增加（>1 cm），淋巴结转移更为常见。MEN-1 并发症的发生率为 1%。体检发现 44%的 GI-NETs 患者存在 GI-NETs。有症状的 GI-NETs 的发生率为 3.4%。有趣的是，77.1%的前肠 GI-NETs 患者患有 A 型胃炎。
结论
我们的研究结果表明，日本和西方国家的 GEP-NETs 存在很大差异，主要是由于 NF-PETs 中 MEN-1 的存在以及 GI-NETs 的位置、症状状态和恶性肿瘤的发生率不同所致。
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