From the Department of Medicine, Division of Hematology and Oncology, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA.
Department of Medicine, Division of Solid Tumor, Gastrointestinal Malignancies, Memorial Sloan Kettering Cancer Center, New York, NY.
Pancreas. 2020 Oct;49(9):1123-1130. doi: 10.1097/MPA.0000000000001658.
Patients with neuroendocrine tumors (NETs) and carcinoid syndrome experience diarrhea that can have a debilitating effect on quality of life. Diarrhea also may develop in response to other hormonal syndromes associated with NETs, surgical complications, medical comorbidities, medications, or food sensitivities. Limited guidance on the practical approach to the differential diagnosis of diarrhea in these patients can lead to delays in appropriate treatment. This clinical review and commentary underscore the complexity in identifying the etiology of diarrhea in patients with NETs. Based on our collective experience and expertise, we offer a practical algorithm to guide medical oncologists and other care providers to expedite effective management of diarrhea and related symptoms in patients with NETs.
神经内分泌肿瘤(NET)和类癌综合征患者会出现腹泻,这可能会对生活质量造成严重影响。腹泻也可能是 NET 相关的其他激素综合征、手术并发症、合并症、药物或食物过敏反应的结果。由于针对 NET 患者腹泻的鉴别诊断方法缺乏实用性指导,可能会导致治疗延误。本文通过临床综述和评论,强调了识别 NET 患者腹泻病因的复杂性。基于我们的临床经验和专业知识,我们提出了一种实用的算法,旨在为肿瘤内科医生和其他医护人员提供指导,以加快 NET 患者腹泻及相关症状的有效管理。