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[胃神经内分泌肿瘤(NET)的差异化手术治疗]

[Differentiated surgical therapy for neuroendocrine tumours (NET) of the stomach].

作者信息

Gockel I, Watzka F, Musholt T J, Lang H

机构信息

Johannes Gutenberg-Universität Mainz, Klinik und Poliklinik für Allgemein- und Abdominalchirurgie, Mainz, Deutschland.

出版信息

Zentralbl Chir. 2010 Jun;135(3):203-9. doi: 10.1055/s-0030-1247279. Epub 2010 Jun 14.

Abstract

Neuroendocrine tumours (NET) of the stomach have increasingly entered into the focus of attention recently by endocrinologists as well as by surgeons on account of new findings on their biological background and their clinical relevance. The discriminating pathogenesis and the basically different biological behaviours of neuroendocrine tumours of the stomach require a differentiated therapeutical treatment for the different sub-types. The differential diagnostic clarification of the basic pathomechanism is therefore of decisive importance. As a consequence of the rarity of this entity, any treatment should be performed in corresponding centres. An interdisciplinary therapy planning, e. g., in the context of specialised inter-disciplinary conferences, such as an interdisciplinary board for endocrine and neuroendocrine tumours, is essential for an optimised management of these tumours. Important aspects of future research should - besides the genetic and molecular biological backgrounds - be the additional and potentially apparent factors for hypergastrinaemia, which induce a dysplastic and perhaps malignant transformation of the hyperplastic changes. Neuroendocrine tumours of the stomach remain a special challenge within the clinical daily routine - not only in the correct classification but also in the optimal surgical therapy.

摘要

由于胃神经内分泌肿瘤(NET)在生物学背景和临床相关性方面有了新的发现,近年来越来越受到内分泌学家和外科医生的关注。胃神经内分泌肿瘤独特的发病机制和基本不同的生物学行为,需要针对不同亚型进行差异化的治疗。因此,对基本病理机制进行鉴别诊断至关重要。由于该疾病罕见,任何治疗都应在相应的中心进行。跨学科的治疗规划,例如在专门的跨学科会议(如内分泌和神经内分泌肿瘤跨学科委员会)的背景下进行,对于优化这些肿瘤的管理至关重要。除了基因和分子生物学背景外,未来研究的重要方面还应包括导致高胃泌素血症的其他潜在明显因素,这些因素会引发增生性改变的发育异常甚至恶变。胃神经内分泌肿瘤在临床日常工作中仍然是一个特殊的挑战——不仅在于正确分类,还在于最佳手术治疗。

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