Khan Mohid Shakil, Caplin Martyn E
Neuroendocrine Tumour Unit, European Neuroendocrine Tumour Society Centre of Excellence, Centre for Gastroenterology, Royal Free Hospital, London, UK.
UCL Cancer Institute, London, UK.
Frontline Gastroenterol. 2013 Jul;4(3):175-181. doi: 10.1136/flgastro-2012-100272. Epub 2013 Mar 21.
The incidence and prevalence of neuroendocrine tumours (NETs) arising from the gastrointestinal tract are increasing. At the time of diagnosis, histological grade, based on Ki-67 proliferation index on a tumour biopsy or specimen, offers prognostication but with often lengthy survival, this may not reflect current tumour biology later in the disease course. Biomarkers, including plasma chromogranin A, urinary 5-hydroxyindole acetic acid and pancreatic specific hormones (insulin, gastrin, vasoactive intestinal peptide), have a role in diagnosis but despite being incorporated into routine clinical practice, there is a lack of robust prospectively collected data investigating their prognostic and predictive value. Given the increasing number of treatment options available for NETs and prolonged survival, there is no agreement on the order of treatment for individual NET patients but the emergence of novel biomarkers and validation of existing ones, in addition to better understanding of the molecular biology, may help solve this clinical problem.
源自胃肠道的神经内分泌肿瘤（NETs）的发病率和患病率正在上升。在诊断时，基于肿瘤活检或标本的Ki-67增殖指数的组织学分级可提供预后信息，但由于生存期往往较长，这可能无法反映疾病后期当前的肿瘤生物学特性。生物标志物，包括血浆嗜铬粒蛋白A、尿5-羟吲哚乙酸和胰腺特异性激素（胰岛素、胃泌素、血管活性肠肽），在诊断中发挥作用，但尽管已纳入常规临床实践，但缺乏前瞻性收集的有力数据来研究它们的预后和预测价值。鉴于可用于NETs的治疗选择数量不断增加以及生存期延长，对于个体NET患者的治疗顺序尚无共识，但除了更好地理解分子生物学外，新型生物标志物的出现和现有生物标志物的验证可能有助于解决这一临床问题。
