Thomaz Araújo Taíssa Maíra, Barra Williams Fernandes, Khayat André Salim, de Assumpção Paulo Pimentel
Oncology Research Center, Federal University of Pará, Pará 66073-005, Brazil.
Chin J Cancer Res. 2017 Apr;29(2):137-143. doi: 10.21147/j.issn.1000-9604.2017.02.06.
Type 1 gastric neuroendocrine tumors (gNETs) are usually small lesions, restricted to mucosal and sub-mucosal layers of corpus and fundus, with low aggressive behavior, for the majority of cases. Nevertheless, some cases present aggressive behavior. The increasing incidence of gNETs brings together a new relevant problem: how to identify potentially aggressive type 1 gNETs. The challenging problem seems to be finding out signs or features able to predict potentially aggressive cases, allowing a tailored approach, since the involved societies dedicated to provide guidelines for management of these neoplasms apparently failed in producing staging systems able to accurately predict prognosis of these tumors. Additionally, it is also important to try to find out explanations for increasing incidence, as well as to identify potential targets aiming to reach better control of this neoplasia. Here, we discuss potential pathways implicated in aggressive behavior, as well as new strategies to improve clinical management of these tumors.
1型胃神经内分泌肿瘤(gNETs)通常是小病灶,大多局限于胃体和胃底的黏膜及黏膜下层,侵袭性较低。然而,有些病例具有侵袭性。gNETs发病率的上升带来了一个新的相关问题:如何识别具有潜在侵袭性的1型gNETs。具有挑战性的问题似乎是找出能够预测潜在侵袭性病例的体征或特征,从而采取针对性的治疗方法,因为致力于为这些肿瘤的管理提供指导方针的相关学会显然未能制定出能够准确预测这些肿瘤预后的分期系统。此外,试图找出发病率上升的原因以及确定旨在更好地控制这种肿瘤的潜在靶点也很重要。在此,我们讨论与侵袭性行为相关的潜在途径以及改善这些肿瘤临床管理的新策略。