Chen Luohai, Zhou Zhiwei, Chen Jie
Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
Department of Gastric Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncoogy in South China, Collaborative Innovative Center for Cancer Medicine, Guangzhou 510060, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2017 Sep 25;20(9):972-976.
American Joint Committeeon Cancer (AJCC) released the eighth edition staging system manual in October 2016. Based on the shortcomings in the seventh edition of AJCC staging system, staging classifications for gastroenteropancreatic neuroendocrine tumor (GEP-NET) were updated. The changes are as follow: small intestinal NET was divided into two groups, duodenal and jejunoileal NET and lymphatic metastasis was redefined into N1 and N2 in jejunoileal NET; stages were condensed except colorectal NET; the staging classification for pancreatic NET proposed by European Neuroendocrine Tumor Society(ENETS) was adopted. However, problems still exist in the eighth edition AJCC staging classifications for GEP-NET. For instance, whether the definitions of N1 and N2 in jejunoileal NET are accurate in clinical management is still less understood. Thus, further clinical validations of the AJCC eighth edition staging system for GEP-NET are needed. Meanwhile, the eighth edition AJCC staging classifications for GEP-NET still did not step towards precision medicine and risks assessment models with high quality are still absent.
美国癌症联合委员会（AJCC）于2016年10月发布了第八版分期系统手册。基于AJCC第七版分期系统的不足之处，对胃肠胰神经内分泌肿瘤（GEP-NET）的分期分类进行了更新。变化如下：小肠神经内分泌肿瘤分为两组，十二指肠和空回肠神经内分泌肿瘤，空回肠神经内分泌肿瘤的淋巴结转移重新定义为N1和N2；除结直肠神经内分泌肿瘤外，各期均进行了合并；采用了欧洲神经内分泌肿瘤学会（ENETS）提出的胰腺神经内分泌肿瘤分期分类。然而，AJCC第八版GEP-NET分期分类仍存在问题。例如，空回肠神经内分泌肿瘤中N1和N2的定义在临床管理中是否准确仍不太清楚。因此，需要对AJCC第八版GEP-NET分期系统进行进一步的临床验证。同时，AJCC第八版GEP-NET分期分类仍未迈向精准医学，高质量的风险评估模型仍然缺乏。
