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胃肠道和胰腺神经内分泌肿瘤的当代治疗及随访方法

Contemporary methods of therapy and follow-up of neuroendocrine tumours of the gastrointestinal tract and the pancreas.

作者信息

Gut Paweł, Fischbach Jakub, Kamiński Grzegorz, Ruchała Marek

机构信息

Department of Endocrinology and Metabolism, Poznan University of Medical Sciences, Poznan, Poland.

出版信息

Contemp Oncol (Pozn). 2012;16(5):371-5. doi: 10.5114/wo.2012.31764. Epub 2012 Nov 20.

Abstract

The growing interest in neuroendocrine tumours is due to the dynamic growth of detection of this type of cancer. Neuroendocrine tumours (neuroendocrine neoplasms - NENs / neuroendocrine tumours - NETs) derive from glands, groups of endocrine cells and diffuse neuroendocrine system cells. Mainly they derive from the gastrointestinal tract (gastroenteropancreatic-neuroendocrine tumours - GEP-NETs). Currently the modified WHO classification from 2010 is widely used. An important element in the choice of treatment is histological maturity based on mitotic activity and on assessment of proliferation activity (Ki-67). The treatment of choice is surgery. In most cases, complete surgical removal is impossible because of the advanced staging at the time of diagnosis. In well-differentiated neoplasms where the expression of somatostatin receptors is expected, patients are qualified for somatostatin analogues therapy. Poorly differentiated lesions are qualified for chemotherapy. In the guidelines of ENETS (European Neuroendocrine Tumor Society) from 2007 the rules concerning monitoring depending on the WHO classification were specified.

摘要

对神经内分泌肿瘤的关注度不断提高,是由于这类癌症的检出率呈动态增长。神经内分泌肿瘤(神经内分泌瘤 - NENs / 神经内分泌肿瘤 - NETs)起源于腺体、内分泌细胞群和弥散神经内分泌系统细胞。主要起源于胃肠道(胃肠胰神经内分泌肿瘤 - GEP - NETs)。目前广泛使用的是2010年修订的世界卫生组织分类。治疗方案选择的一个重要因素是基于有丝分裂活性和增殖活性评估(Ki - 67)的组织学成熟度。首选治疗方法是手术。在大多数情况下,由于诊断时分期较晚,无法进行完整的手术切除。对于预期表达生长抑素受体的高分化肿瘤患者,适合使用生长抑素类似物治疗。低分化病变适合化疗。在2007年欧洲神经内分泌肿瘤学会(ENETS)的指南中,明确了根据世界卫生组织分类进行监测的规则。

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