Singh Simron, Dey Chris, Kennecke Hagen, Kocha Walter, Maroun Jean, Metrakos Peter, Mukhtar Tariq, Pasieka Janice, Rayson Daniel, Rowsell Corwyn, Sideris Lucas, Wong Ralph, Law Calvin
Department of Medicine, Odette Cancer Centre - Sunnybrook Hospital, University of Toronto, Toronto, ON, Canada,
Ann Surg Oncol. 2015 Aug;22(8):2685-99. doi: 10.1245/s10434-014-4145-0. Epub 2014 Nov 4.
Pancreatic neuroendocrine tumors (pNETs) are rare heterogeneous tumors that have been steadily increasing in both incidence and prevalence during the past few decades. Pancreatic NETs are categorized as functional (F) or nonfunctional (NF) based on their ability to secrete hormones that elicit clinically relevant symptoms. Specialized diagnostic tests are required for diagnosis. Treatment options are diverse and include surgical resection, intraarterial hepatic therapy, and peptide receptor radionuclide therapy (PRRT). Systemic therapy options include targeted agents as well as chemotherapy when indicated. Diagnosis and management should occur through a collaborative team of health care practitioners well-experienced in managing pNETs. Recent advances in pNET treatment options have led to the development of the Canadian consensus document described in this report. The discussion includes the epidemiology, classification, pathology, clinical presentation and prognosis, imaging and laboratory testing, medical and surgical management, and recommended treatment algorithms for pancreatic neuroendocrine cancers.
胰腺神经内分泌肿瘤（pNETs）是罕见的异质性肿瘤，在过去几十年中其发病率和患病率都在稳步上升。胰腺神经内分泌肿瘤根据其分泌引发临床相关症状的激素的能力分为功能性（F）或无功能性（NF）。诊断需要专门的诊断测试。治疗选择多种多样，包括手术切除、肝动脉内治疗和肽受体放射性核素治疗（PRRT）。全身治疗选择包括靶向药物以及在有指征时进行化疗。诊断和管理应由在管理pNETs方面经验丰富的医疗保健从业者组成的协作团队进行。pNET治疗选择的最新进展促成了本报告中所述的加拿大共识文件的制定。讨论内容包括胰腺神经内分泌癌的流行病学、分类、病理学、临床表现和预后、影像学和实验室检查、药物和手术管理以及推荐的治疗算法。
