De Angelis C, Manfrè S F, Bruno M, Pellicano R
Department of Gastroenterology and Hepatology Molinette Hospital, Turin, Italy -
Minerva Med. 2014 Oct;105(5):363-70.
Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are a group of neoplasms arising from the diffuse neuroendocrine system of the gastrointestinal (GI) tract. They often represent a diagnostic challenge because of their little dimensions, the deep localization into the retroperitoneum or in extramucosal sites, the possibility to be multilocated and the heterogeneous patterns of presentation. Endoscopic ultrasound (EUS) is a cost-effective technique that enables to look very definitely at a suspicious mass and at the surrounding area both within the GI wall and in the pancreas, allowing to precisely assess T and N stage. Under EUS-guidance it is possible to obtain tissue samples in order to reach a definitive diagnosis and to establish the tumor grade. In the therapeutic field, EUS is crucial to assess the safety and the feasibility of resective endoscopic techniques for the GI-wall NETs and it can guide local ablative techniques for pancreatic NETs. After treatment, EUS can be successfully useful to assess complete endoscopic resection and to follow-up resected or ablated patients. It is so evident that EUS has a role in the whole route of NETs management, from diagnosis, evaluation, grading and staging assessment, to therapy and consequent follow-up.
胃肠胰神经内分泌肿瘤（GEP-NETs）是一组起源于胃肠道（GI）弥漫性神经内分泌系统的肿瘤。由于其尺寸小、位于腹膜后或黏膜外部位较深、可能为多部位发生以及表现形式多样，它们常常构成诊断挑战。内镜超声（EUS）是一种经济有效的技术，能够非常确切地观察可疑肿块及其在胃肠道壁和胰腺内的周围区域，从而精确评估T和N分期。在EUS引导下，可以获取组织样本以明确诊断并确定肿瘤分级。在治疗领域，EUS对于评估胃肠道壁NETs内镜切除技术的安全性和可行性至关重要，并可指导胰腺NETs的局部消融技术。治疗后，EUS可成功用于评估内镜下完全切除情况，并对接受切除或消融治疗的患者进行随访。很明显，EUS在NETs管理的整个过程中都发挥着作用，从诊断、评估、分级和分期评估到治疗及后续随访。
