Liu De-Jun, Hua Rong, Sun Yong-Wei
Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China.
Chin Clin Oncol. 2019 Apr;8(2):20. doi: 10.21037/cco.2019.04.01.
Pancreatic neuroendocrine neoplasms (P-NENs) are a group of pathologically and clinically heterogeneous tumors. In the past several decades, the incidence has been increasing. In 2010, the WHO presented a new classification dividing P-NENs into well-differentiated neuroendocrine tumors (NETs) and poorly-differentiated neuroendocrine carcinomas (NECs). Surgery is the primary and most important treatment for P-NENs, and is also the only possible curative procedure. By the 2018 NCCN guideline, observation can be considered for <1 cm, low-grade asymptomatic nonfunctional P-NETs. And for patients who are not suitable for surgery, somatostatin analogues, targeted therapy, radionuclides, ablation therapies, (chemo)embolisation and chemotherapy should be considered to improve and maintain a good quality of life. More than one hundred years has passed since termed, and in recent years, more and more molecule mechanism about P-NENs have been discovered. With the addition of several new agents, survival improved over the time. All this made P-NENs great promise.
胰腺神经内分泌肿瘤(P-NENs)是一组在病理和临床上具有异质性的肿瘤。在过去几十年中,其发病率一直在上升。2010年,世界卫生组织(WHO)提出了一种新的分类方法,将P-NENs分为高分化神经内分泌肿瘤(NETs)和低分化神经内分泌癌(NECs)。手术是P-NENs的主要且最重要的治疗方法,也是唯一可能的治愈性手段。根据2018年美国国立综合癌症网络(NCCN)指南,对于直径小于1厘米、低级别无症状非功能性P-NETs可考虑观察。而对于不适合手术的患者,应考虑使用生长抑素类似物、靶向治疗、放射性核素、消融治疗、(化疗)栓塞和化疗,以改善并维持良好的生活质量。自该疾病被命名以来已过去一百多年,近年来,关于P-NENs的分子机制被发现得越来越多。随着几种新药物的加入,患者的生存期随时间得到了改善。所有这些都让P-NENs前景广阔。