Neuroendocrine tumors of the small bowels are on the rise: Early aspects and management
Neuroendocrine tumors of the small bowels are on the rise: Early aspects and management
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DOI：
10.4253/wjge.v2.i10.325
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发表时间：
2010-10-16
影响因子：
2
通讯作者：
Kloeppel, Gnter
中科院分区：
文献类型：
--
作者：
Scheruebl, Hans;Jensen, Robert T.;Kloeppel, Gnter
小肠的神经内分泌肿瘤正在上升。在过去的35年里，美国的这一数字增长了300%-500%。与此同时，他们的预后也得到了很大的改善。今天，大多数十二指肠神经内分泌肿瘤（NETs）都是“偶然”发现的，因此在早期就被发现。分化良好、不大于10 mm且局限于粘膜/粘膜下层的十二指肠NET可通过内窥镜切除。十二指肠NET的管理范围在10和20 mm之间，需要进行跨学科的讨论。超声内镜是确定肿瘤大小和浸润深度的首选方法。对于直径大于20 mm的分化良好的十二指肠NET肿瘤、局限性散发性胃泌素瘤（任何大小）和局限性分化不良的NE癌，建议进行手术。建议对任何回肠NET进行手术。晚期回肠NETs伴类癌综合征用长效生长抑素类似物治疗。该治疗显著改善了回肠转移性NET患者的（无进展）生存期。对于最佳的NET管理，肿瘤生物学，肿瘤的类型，定位和阶段，以及患者的个人情况必须考虑在内。(C)2010年百世登。All rights reserved.
Neuroendocrine tumors of the small bowel are on the rise. In the US they have increased by 300%-500% in the last 35 years. At the same time their prognosis is much improved. Today, most neuroendocrine tumors (NETs) of the duodenum are detected "incidentally" and therefore recognized at an early stage. Duodenal NETs which are well differentiated, not larger than 10 mm and limited to the mucosa/submucosa can be endoscopically resected. The management of duodenal NETs ranging between 10 and 20 mm needs an interdisciplinary discussion. Endoscopic ultrasound is the method of choice to determine tumor size and depth of infiltration. Surgery is recommended for well-differentiated duodenal NET tumors greater than 20 mm, for localized sporadic gastrinomas (of any size) and for localized poorly differentiated NE cancers. Surgery is recommended for any ileal NET. Advanced ileal NETs with a carcinoid syndrome are treated with long-acting somatostatin analogs. This treatment signifi-cantly improves (progression-free) survival in patients with metastatic NETs of the ileum. For optimal NET management, tumor biology, type, localization and stage of the neoplasm, as well as the patient's individual circumstances have to be taken into account. (C) 2010 Baishideng. All rights reserved.