Bavarian Cancer Registry, Bavarian Health and Food Safety Authority, Nuremberg, Germany.
Department of Internal Medicine and Gastroenterology, Asklepios Tumour Centre Hamburg and Asklepios Hospital St. Georg, Hamburg, Germany.
Cancer Med. 2023 Oct;12(19):19949-19958. doi: 10.1002/cam4.6510. Epub 2023 Sep 22.
Neuroendocrine neoplasms (NEN) are rare and heterogeneous epithelial tumors, occurring throughout the body. For gastroenteropancreatic (GEP)-NEN, rising incidence rates were reported for the last decades, with underlying causes remaining largely unexplained. We evaluated NEN trends stratifying by their histologic subtypes.
Incident cases of GEP-NEN diagnosed between 2005 and 2019 were retrieved from the prospective, population-based Bavarian Cancer Registry. GEP-NEN were divided in their histologic subtypes, that is, neuroendocrine tumors (NET) G1, NET G2/G3, other NET versus small-cell neuroendocrine carcinoma (NEC), large-cell NEC, and other NEC. We calculated annual age-standardized incidence rates (ASIRs) per 100,000 persons for the total of GEP-NEN, NEN histologic subtypes, and tumor sites. We used an annual percentage change (APC) approach including a joinpoint analysis to investigate NEN incidence trends.
ASIR of GEP-NEN rose from 2.2 in 2005 to 4.8 in 2019, characterized by a significant increase until 2012 (APC 2005-2012: 10.1%), followed by modest rise (APC 2012-2019: 1.5%). In the last decade, this increase was mainly driven by the rise of NET G1 and G2/G3, while incidence for NEC declined. Over the study period, ASIR increased significantly for all GEP-sites except the colon. APCs were largest for the stomach, the appendix, the pancreas, and the rectum.
This study found a significant increase in the incidence of GEP-NET. Though this development may partially be attributable to the increased use of advanced detection techniques and changes in NEN classification, further research should also focus on the identification of NEN risk factors.
神经内分泌肿瘤（NEN）是一种罕见的异质性上皮肿瘤，可发生于全身各处。在过去几十年中，胃肠胰神经内分泌肿瘤（GEP-NEN）的发病率呈上升趋势，但根本原因仍在很大程度上尚未阐明。我们通过对其组织学亚型进行分层，评估了 NEN 的趋势。
从前瞻性、基于人群的巴伐利亚癌症登记处检索了 2005 年至 2019 年间诊断的 GEP-NEN 病例。GEP-NEN 根据其组织学亚型分为神经内分泌肿瘤（NET）G1、NET G2/G3、其他 NET 与小细胞神经内分泌癌（NEC）、大细胞 NEC 和其他 NEC。我们计算了 GEP-NEN、NEN 组织学亚型和肿瘤部位的总发病率、年龄标准化发病率（ASIR），以每 10 万人中有多少人为单位。我们采用年度百分比变化（APC）方法，包括联合点分析，以研究 NEN 发病率趋势。
GEP-NEN 的 ASIR 从 2005 年的 2.2 上升到 2019 年的 4.8，2012 年前呈显著上升趋势（2005-2012 年 APC：10.1%），之后上升幅度较小（2012-2019 年 APC：1.5%）。在过去十年中，这种增长主要是由于 NET G1 和 G2/G3 的增加，而 NEC 的发病率则下降。在研究期间，除了结肠外，所有 GEP 部位的 ASIR 均显著增加。APC 最大的是胃、阑尾、胰腺和直肠。
本研究发现 GEP-NET 的发病率显著增加。尽管这种发展部分可能归因于先进检测技术的使用增加和 NEN 分类的变化，但进一步的研究还应关注 NEN 危险因素的确定。
