Pellicano Rinaldo, Fagoonee Sharmila, Altruda Fiorella, Bruno Mauro, Saracco Giorgio M, De Angelis Claudio
Department of Gastroenterology and Hepatology, Molinette Hospital, Turin, Italy -
Minerva Endocrinol. 2016 Dec;41(4):490-8.
Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are a heterogeneous group of tumors deriving from the gastrointestinal (GI) neuroendocrine system. Since these neoplasms are usually very small, located deeply within the retroperitoneum or into an extramucosal site of the GI tract and, lastly, because they may be multi-sited, radiological imaging modalities, in combination with endoscopy, are the diagnostic workhorses in patients with GEP-NETs. Endoscopic approach is useful for detection, bioptic diagnosis and curative resection of small GEP-NETs of stomach, duodenum, jejuno-ileum, and colon-rectum. Moreover, endoscopic ultrasonography (EUS), associated with high frequency miniprobes, is a valuable procedure in regional staging of lesions of the GI wall and can provide information which has a remarkable impact on therapeutic choices. EUS is still the sole technique, in a substantial number of cases, providing a definitive diagnosis of pancreatic insulinoma and it detects and follows small lesions of the pancreas in patients with Multiple Endocrine Neoplasia type 1 syndrome. EUS should be performed in those cases in which morphological or molecular imaging modalities need to be supported because of negative or dubious results. In this review we describe the applications of endoscopic procedures in the management of GEP-NETs.
胃肠胰神经内分泌肿瘤（GEP-NETs）是一组起源于胃肠（GI）神经内分泌系统的异质性肿瘤。由于这些肿瘤通常非常小，位于腹膜后深处或胃肠道的黏膜外部位，而且它们可能是多部位发生的，因此放射影像学检查结合内镜检查，是GEP-NETs患者的主要诊断手段。内镜检查方法对于胃、十二指肠、空肠-回肠和结肠-直肠的小GEP-NETs的检测、活检诊断和根治性切除很有用。此外，内镜超声检查（EUS）与高频微型探头联合使用，在胃肠道壁病变的区域分期中是一种有价值的检查方法，并且可以提供对治疗选择有显著影响的信息。在大量病例中，EUS仍然是唯一能对胰腺胰岛素瘤做出明确诊断的技术，并且它能检测和随访1型多发性内分泌肿瘤综合征患者胰腺的小病变。在因结果为阴性或可疑而需要支持形态学或分子影像学检查的情况下，应进行EUS检查。在本综述中，我们描述了内镜检查在GEP-NETs管理中的应用。
