Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Gynecol Oncol. 2011 Jul;122(1):190-8. doi: 10.1016/j.ygyno.2011.04.011.
Neuroendocrine tumors of the gynecologic tract are rare, and pose a significant clinical challenge because of the tumor heterogeneity and lack of standardized guidelines for treatment. This manuscript summarizes the available literature concerning these tumors in an effort to provide the clinician a framework from which to guide patient management.
MEDLINE was searched for all research articles published in English between January 1, 1966 and March 1, 2011 in which the studied population included women diagnosed with neuroendocrine tumors of the gynecologic tract. Although preference was given to prospective studies, studies were not limited by design or by numbers of subjects given the limited availability of reports.
Most, but not all, neuroendocrine tumors of the gynecologic tract have an aggressive clinical course and those of the cervix histologically and clinically share similarities with small cell lung cancer. Cumulative data supports a multi-modality therapeutic strategy. A proposed management algorithm for neuroendocrine carcinomas of the cervix is outlined. For less frequent disease sites including the adnexa, uterus, vagina and vulva, as well as well differentiated carcinoid tumors, surgical resection is appropriate in selected cases. Etoposide/platinum based chemotherapy is used for neuroendocrine carcinomas but not for well differentiated carcinoid tumors. Well differentiated carcinoid and atypical carcinoid tumors should be managed similar to gastroenteropancreatic NETs (GEP-NETs).
Most neuroendocrine tumors of the gynecologic tract require a multi-modality therapeutic approach, determined by extent of disease and primary organ of involvement. Pathologic diagnosis is critical to guide therapy.
妇科生殖道神经内分泌肿瘤较为罕见，由于肿瘤异质性和缺乏标准化治疗指南，给临床治疗带来了巨大挑战。本文总结了目前关于这些肿瘤的相关文献，旨在为临床医生提供一个指导患者管理的框架。
检索了 1966 年 1 月 1 日至 2011 年 3 月 1 日期间以英文发表的所有关于妇科生殖道神经内分泌肿瘤的研究文章，研究人群包括被诊断为妇科生殖道神经内分泌肿瘤的女性。尽管我们优先考虑前瞻性研究，但由于报告数量有限，因此并未将设计或研究对象数量作为研究的限制条件。
大多数妇科生殖道神经内分泌肿瘤（但并非全部）具有侵袭性的临床病程，且宫颈神经内分泌肿瘤在组织学和临床方面与小细胞肺癌相似。累积数据支持多模式治疗策略。本文概述了一种用于治疗宫颈癌神经内分泌癌的管理算法。对于不太常见的发病部位，包括附件、子宫、阴道和外阴，以及分化良好的类癌肿瘤，在选择的情况下手术切除是合适的。依托泊苷/铂类化疗用于治疗神经内分泌癌，但不适用于分化良好的类癌肿瘤。分化良好的类癌和非典型类癌肿瘤的治疗应类似于胃肠胰神经内分泌肿瘤（GEP-NETs）。
大多数妇科生殖道神经内分泌肿瘤需要采用多模式治疗方法，具体取决于疾病的范围和主要受累器官。病理诊断对于指导治疗至关重要。
