胰腺神经内分泌肿瘤当前预后预测系统的系统回顾。
Systematic review of current prognostication systems for pancreatic neuroendocrine neoplasms.
机构信息
Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital.
Division of Medical Oncology, National Cancer Centre, Singapore; Duke-NUS Medical School, Singapore.
出版信息
Surgery. 2019 Apr;165(4):672-685. doi: 10.1016/j.surg.2018.10.031. Epub 2018 Dec 14.
BACKGROUND
Pancreatic neuroendocrine neoplasms are a heterogenous group of rare tumors whose natural history remains poorly defined. Accurate prognostication of pancreatic neuroendocrine neoplasms is essential for guiding clinical decisions. This paper aims to summarize all the commonly utilized and recently proposed prognostication systems for pancreatic neuroendocrine neoplasms published in the literature to date.
METHODS
A systematic review of Pubmed, Scopus, and Embase databases, of the period from January 1, 2000-November 29, 2016, was conducted to identify all published articles reporting on prognostication systems of pancreatic neuroendocrine neoplasms.
RESULTS
A total of 23 articles were included in our review, and a total of 25 classification systems were identified. There were 2 modifications of the World Health Organization 2004 criteria, 4 modifications of the World Health Organization 2010 criteria, 2 modifications of the American Joint Committee on Cancer 2010 staging system, 3 modifications of the European Neuroendocrine Tumor Society 2006 tumor, node, metastasis staging system, 7 novel categorial classification systems, and 2 novel proposed continuous classifications. The most commonly included variables included age, size of tumor, presence of distant and lymph node metastases, Ki-67 index, and mitotic count.
CONCLUSION
Numerous prognostication systems have been proposed for pancreatic neuroendocrine neoplasms, of which the most commonly used systems presently include the World Health Organization 2010 criteria and the two tumor, node, metastasis staging systems by the European Neuroendocrine Tumor Society and the American Joint Commission on Cancer. However, prognostication systems for pancreatic neuroendocrine neoplasms continue to evolve with time as more prognostication factors are identified. More validation and comparative studies are needed to identify the most effective prognostication system.
背景
胰腺神经内分泌肿瘤是一组异质性罕见肿瘤，其自然史仍未得到明确界定。准确预测胰腺神经内分泌肿瘤对于指导临床决策至关重要。本文旨在总结迄今为止文献中报道的所有常用和最近提出的用于预测胰腺神经内分泌肿瘤的预后系统。
方法
对 Pubmed、Scopus 和 Embase 数据库进行了系统回顾，检索时间为 2000 年 1 月 1 日至 2016 年 11 月 29 日，以确定所有报道胰腺神经内分泌肿瘤预后系统的已发表文章。
结果
共有 23 篇文章被纳入我们的综述，共确定了 25 个分类系统。其中有 2 个是对世界卫生组织 2004 年标准的修改，4 个是对世界卫生组织 2010 年标准的修改，2 个是对美国癌症联合委员会 2010 年分期系统的修改，3 个是对欧洲神经内分泌肿瘤学会 2006 年肿瘤、淋巴结、转移分期系统的修改，7 个是新的分类系统，2 个是新提出的连续分类系统。最常包含的变量包括年龄、肿瘤大小、远处和淋巴结转移的存在、Ki-67 指数和有丝分裂计数。
结论
已经提出了许多用于胰腺神经内分泌肿瘤的预后系统，目前最常用的系统包括世界卫生组织 2010 年标准以及欧洲神经内分泌肿瘤学会和美国癌症联合委员会的两个肿瘤、淋巴结、转移分期系统。然而，随着更多的预后因素被确定，胰腺神经内分泌肿瘤的预后系统仍在不断发展。需要更多的验证和比较研究来确定最有效的预后系统。
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