Diagnosis, Natural History, Management and tumor biology of Gastrinomas

无论患者是否患有MEN1，胃泌素瘤都是最常见的有症状的恶性PET，有足够数量的此类患者被纳入我们的方案，以便进行系统的评估。目前正在进行研究，评估这些肿瘤的自然病史，包括肿瘤的表现、初步诊断和决定预后的因素的定义。我们的研究已经确定了25%的胃泌素瘤患者具有侵袭性生长，25%的患者患有多发性内分泌肿瘤1型(MEN1)。在这一年中，一项关于MEN1患者甲状旁腺功能亢进症手术治疗的前瞻性研究完成，显示他们的疾病比没有胃泌素瘤的MEN1患者更严重；一项关于MEN1/ZES患者胃类癌发生的前瞻性研究已经完成，确定了这些患者中这些肿瘤的发生率，并为它们的存在提出了适当的随访和预后因素，并发表了一些关于治疗各种疾病方面的共识会议和立场论文。

Gastrinomas are the most common symptomatic, malignant PET in patients with or without MEN1 and sufficient numbers of these patients have been entered into our protocols to allow systematic assessment. Studies are now underway, evaluating the natural history of these tumors including the presentation and initial diagnosis and definition of factors determining prognosis. Our studies have identified a cohort of 25% of patients in whom the gastrinomas have aggressive growth and 25% who have multiple endocrine neoplasia type 1 (MEN1). During this year a prospective study of surgical treatment of hyperparathyroidism in MEN1 patients was completed showing that they have more severe disease than occurs in patients with MEN1 without gastrinomas; a prosepctive study of the occurrence of gastric carcinoids in MEN1/ZES patients was complete establishing the incidence of these tumors in these patients and recommending appropriate followup and prognostic factors for their presence, and a number of consensus conferences and position papers on treatment of various disease aspects were published.