支气管肺系统的神经内分泌肿瘤(典型和非典型类癌肿瘤):目前的诊断和治疗策略。2011 年 2 月在德国魏玛举行的专家会议的结论。
Neuroendocrine tumors of the bronchopulmonary system (typical and atypical carcinoid tumors): current strategies in diagnosis and treatment. Conclusions of an expert meeting February 2011 in Weimar, Germany.
机构信息
Klinik für Innere Medizin, Gastroenterologie und Endokrinologie, Zentralklinik Bad Berka, Bad Berka, Germany.
出版信息
Oncol Res Treat. 2014;37(5):266-76. doi: 10.1159/000362430. Epub 2014 Apr 14.
Neuroendocrine tumors (NETs; syn. carcinoid tumors) are highly or moderately differentiated neoplasms. They comprise a large variety of rare and heterogeneous tumors with an estimated incidence of 3-5/100,000/year. They can arise in virtually every internal organ, but mainly occur in the gastroenteropancreatic and bronchopulmonary systems. Around 25% of the NETs are localized in the bronchopulmonary system. Approximately 2% of all lung tumors are NETs. According to the World Health Organization (WHO) classification of lung tumors, bronchopulmonary NETs are subdivided into typical carcinoids (TCs) and atypical carcinoids (ACs). The parameter with the highest impact on NET behavior and prognosis is the histological classification and staging according to the tumor/node/metastasis (TNM) system. The diagnosis of NETs is established by histological examination and the immunohistochemical detection of general neuroendocrine markers, such as chromogranin A (CgA) and synaptophysin. Serum markers and the use of functional imaging techniques are important additive tools to establish the diagnosis of a NET. The only curative option for lung NETs is complete surgical resection. Beyond that, the currently available interdisciplinary therapeutic options are local ablation, biotherapy (somatostatin analogues), or chemotherapy. New therapeutic options such as peptide receptor radionuclide therapy (PRRT) and molecularly targeted therapies achieve promising results and are under further evaluation. This report is a consensus summary of the interdisciplinary symposium 'Neuroendocrine Tumors of the Lung and of the Gastroenteropancreatic System (GEP NET) - Expert Dialogue' held on February 25-26, 2011 in Weimar, Germany. At this conference, a panel of 23 German experts shared their knowledge and exchanged their thoughts about research, diagnosis, and clinical management of NETs, whereby special attention was paid to NETs of the respiratory tract.
神经内分泌肿瘤(NET;亦称类癌肿瘤)是高度或中度分化的肿瘤。它们由各种罕见和异质性肿瘤组成,估计每年发病率为 3-5/100000。它们几乎可以发生在所有内部器官中,但主要发生在胃肠胰和支气管肺系统。大约 25%的 NET 发生在支气管肺系统。大约 2%的所有肺部肿瘤是 NET。根据世界卫生组织(WHO)肺部肿瘤分类,支气管肺 NET 分为典型类癌(TC)和非典型类癌(AC)。对 NET 行为和预后影响最大的参数是根据肿瘤/淋巴结/转移(TNM)系统进行的组织学分类和分期。NET 的诊断通过组织学检查和一般神经内分泌标志物(如嗜铬粒蛋白 A(CgA)和突触素)的免疫组织化学检测来确立。血清标志物和功能成像技术的使用是建立 NET 诊断的重要附加工具。肺部 NET 的唯一治愈方法是完全手术切除。除此之外,目前可用的多学科治疗选择包括局部消融、生物治疗(生长抑素类似物)或化疗。肽受体放射性核素治疗(PRRT)和分子靶向治疗等新的治疗选择取得了有希望的结果,正在进一步评估中。本报告是 2011 年 2 月 25-26 日在德国魏玛举行的“肺部和胃肠胰神经内分泌肿瘤(GEP NET)-专家对话”跨学科研讨会的共识总结。在本次会议上,由 23 名德国专家组成的小组分享了他们在 NET 研究、诊断和临床管理方面的知识和思想,特别关注了呼吸道 NET。