Department of Surgery, University of Colorado Anschutz Medical Campus, Division of GI, Tumor and Endocrine Surgery, Academic Office One, 12631 East 17th Avenue, C311, Aurora, CO 80045, USA.
Expert Rev Gastroenterol Hepatol. 2013 Jul;7(5):477-90. doi: 10.1586/17474124.2013.811058.
Pancreatic neuroendocrine tumors (PanNETs) have increased in incidence in the USA over the last 20 years. Although PanNETs are often misconceived as being indolent tumors as they have a far more favorable prognosis over pancreatic adenocarcinoma, roughly 60-70% of patients have metastatic disease at the time of diagnosis due to presentation late in the disease process. While improvements in imaging modalities allow for early detection and better tumor localization, recent advancements in basic science, as well as surgical and medical management of PanNETs have further improved the prognosis. The mainstay of therapy for localized PanNETs is surgical intervention, which has become safer and is slowly shifting towards a more minimally invasive approach. However, the prognosis still remains relatively bleak for patients with unresectable disease. Fortunately, novel molecular targeted therapies, such as everolimus and sunitinib, have recently come into the limelight and have shown significant promise for the treatment of locally advanced and metastatic disease.
过去 20 年来，美国的胰腺神经内分泌肿瘤（PanNETs）发病率有所上升。虽然 PanNETs 通常被误解为惰性肿瘤，因为它们的预后比胰腺腺癌好得多，但由于疾病进程晚期出现，大约 60-70%的患者在诊断时已经发生转移。虽然成像方式的改进可以实现早期发现和更好的肿瘤定位，但最近在基础科学、手术和 PanNETs 的医学管理方面的进展进一步改善了预后。局限性 PanNETs 的主要治疗方法是手术干预，这种方法已经变得更加安全，并且正在慢慢转向更微创的方法。然而，对于无法手术的患者，预后仍然相对较差。幸运的是，新型分子靶向治疗药物，如依维莫司和舒尼替尼，最近备受关注，并为局部晚期和转移性疾病的治疗带来了显著的希望。
