Gilis-Januszewska Aleksandra, Baczyńska Ewelina, Szybiński Piotr, Sowa-Staszczak Anna, Trofimiuk Małgorzata, Pach Dorota, Tomaszewska Romana, Hubalewska-Dydejczyk Alicja
Katedra i Klinika Endokrynologii, Uniwersytet Jagielloński, Collegium Medicum, Kraków.
Przegl Lek. 2009;66(12):1052-61.
Gastric neuroendocrine tumors (NET ventriculi) are rare neoplasms of the gastrointestinal tract, increasing in incidence over last fifty years, what partly could be explained by the common use of upper gastrointestinal tract endoscopy. Pathogenesis of the NET ventriculi is not fully understood, however it is well known, that in all NET ventriculi types there is a hyperplasia of enterochromaffine-like cells (ECL) related to different stimuli. NET ventriculi type 1 is related to autoimmunological atrophic gastritis and hypergastrinaemia, NET ventriculi type 2 with hypergastrinemia in the course of Zollinger-Ellison syndrome associated with multiple endocrine neoplasia (MEN 1) syndrome, NET ventriculi type 3 are sporadic tumors not related to hypergastrinaemia, usually with poor prognosis. Localization of tumors and possible metastases, histo-pathological confirmation of the neoplasm type and defining the source of hypergastrinaemia is essential in diagnostic of NET ventriculi. Treatment dependent on the NET ventriculi type is based on endoscopic or surgical tumor excision in type 1 and 2 and surgical radical treatment in type 3. There is an increased interest in the use of somatostatin analogues (SSA) both in type 1 and in cases with dissemination of the disease. Advances in understanding of the pathogenesis and recent development of medical techniques leads to the improvement of diagnostic and therapy in these group of neoplasms.
胃神经内分泌肿瘤是胃肠道的罕见肿瘤,在过去五十年中发病率不断上升,部分原因可能是上消化道内镜检查的普遍使用。胃神经内分泌肿瘤的发病机制尚未完全明确,但众所周知,在所有类型的胃神经内分泌肿瘤中,嗜银样细胞(ECL)增生与不同刺激有关。1型胃神经内分泌肿瘤与自身免疫性萎缩性胃炎和高胃泌素血症有关,2型胃神经内分泌肿瘤与佐林格-埃利森综合征伴多发性内分泌腺瘤病(MEN 1)综合征过程中的高胃泌素血症有关,3型胃神经内分泌肿瘤是散发性肿瘤,与高胃泌素血症无关,通常预后较差。肿瘤的定位及可能的转移、肿瘤类型的组织病理学确诊以及高胃泌素血症来源的确定对胃神经内分泌肿瘤的诊断至关重要。治疗取决于胃神经内分泌肿瘤的类型,1型和2型基于内镜或手术切除肿瘤,3型则采用手术根治性治疗。在1型以及疾病播散的病例中,对生长抑素类似物(SSA)的应用兴趣日益增加。对发病机制认识的进展以及医学技术的最新发展促使这类肿瘤的诊断和治疗得到改善。