Diagnosis and treatment of carcinoid tumors.
Diagnosis and treatment of carcinoid tumors.
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DOI：
10.1586/14737140.3.6.863
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发表时间：
2003-12-01
影响因子：
3.3
通讯作者：
Oberg, Kjell
中科院分区：
文献类型：
--
作者：
Oberg, Kjell
类癌属于神经内分泌肿瘤家族，通常生长缓慢，具有独特的生物学和临床特征。这些肿瘤的发病率约为2.5/100，000人每年。尽管世界卫生组织有了新的分类，但临床上仍沿用前肠、中肠和后肠肿瘤的分类系统。类癌的组织病理学的确定是极其重要的，包括嗜铬粒蛋白A，突触素，血清素和胃泌素的特异性免疫组织化学染色。通过Ki 67测量的增殖能力用于指导即将进行的医学治疗。定位程序包括计算机断层扫描，超声，磁共振成像，生长抑素受体显像和正电子发射断层扫描。手术仍然是治疗的基石，也是治愈的唯一机会。其他细胞减灭术包括射频消融、激光治疗和化疗栓塞。生物治疗包括细胞毒性药物，如生长抑素类似物和干扰素-α，应适用于生长缓慢的肿瘤。顺铂、足叶乙甙、链脲佐菌素和5-氟脲嘧啶的联合方案应保留用于治疗高度增殖的肿瘤。类癌的未来治疗将基于特定的肿瘤生物学，治疗将针对每个患者进行定制。新的治疗方法，如抗血管生成剂和新的长效生长抑素类似物，以及肿瘤靶向治疗的进一步发展，将在不久的将来进入临床使用。
Carcinoid tumors belong to the family of neuroendocrine tumors, which are usually slow growing with distinct biological and clinical characteristics. The incidence of these tumors is approximately 2.5 in 100,000 people per year. The former classification system of foregut, midgut and hindgut tumors is still used in clinical routine, although there is a new World Health Organization classification. Determination of the histopathology of carcinoid tumors is of utmost importance and involves specific immunohistochemical staining for chromogranin A, synaptophysin, serotonin and gastrin. Proliferation capacity measured by Ki67 is used to guide forthcoming medical treatment. Localization procedures include computerized tomography, ultrasound, magnetic resonance imaging, somatostatin receptor scintigraphy and positron emission tomography. Surgery remains the cornerstone of treatment and provides the only chance of a cure. Other cytoreductive procedures include radiofrequency ablation, laser treatment and chemoembolization. Biological treatment includes cytotoxic agents, such as somatostatin analogs and interferon-alpha, which should be applied in slow-growing neoplasms. Combination regimens including cisplatin, etoposide, streptozotocin and 5-fluorouracil should be reserved for treatment of highly proliferating tumors. Future therapy of carcinoid tumors will be based on the specific tumor biology and treatment will be customized for each individual patient. New therapies, such as antiangiogenic agents and new, long-acting somatostatin analogs, together with further development of tumor-targeted treatments, will come into clinical use in the near future.