Oncologie Endocrinienne et Médecine Nucléaire, Institut Gustave Roussy, Villejuif, France.
Neuroendocrine Tumour Unit, Royal Free Hospital, London, United Kingdom.
Neuroendocrinology. 2019;108(1):7-17. doi: 10.1159/000493980. Epub 2018 Sep 24.
Pulmonary carcinoids (PCs) display the common features of all well-differentiated neuroendocrine neoplasms (NEN) and are classified as low- and intermediate-grade malignant tumours (i.e., typical and atypical carcinoid, respectively). There is a paucity of randomised studies dedicated to advanced PCs and management principles are drawn from the larger gastroenteropancreatic NEN experience. There is growing evidence that NEN anatomic subgroups have different biology and different responses to treatment and, therefore, should be investigated as separate entities in clinical trials. In this review, we discuss the existing evidence and limitations of tumour classification, diagnostics and staging, prognostication, and treatment in the setting of PC, with focus on unmet medical needs and directions for the future.
肺类癌(PCs)具有所有分化良好的神经内分泌肿瘤(NEN)的共同特征,被分类为低级别和中级别恶性肿瘤(即典型和非典型类癌)。目前针对晚期 PCs 的随机研究很少,治疗原则主要借鉴于更大的胃肠胰腺 NEN 经验。越来越多的证据表明,NEN 的解剖亚组具有不同的生物学特性和对治疗的不同反应,因此在临床试验中应将它们作为独立实体进行研究。在本文综述中,我们讨论了在 PC 背景下肿瘤分类、诊断和分期、预后和治疗方面的现有证据和局限性,重点关注未满足的医疗需求和未来的发展方向。