Diagnosis, Natural History, Management,tumor biology of Gastrinomas/PETs

胃鞘瘤是有MEN1或没有MEN1的患者中最常见的症状性恶性PET，我们的研究方案中纳入了足够数量的此类患者，以便进行系统评估。目前正在进行研究，评估这些肿瘤的自然史，包括确定决定预后和死亡原因的因素。我们的研究已经确定了一组患者，其中25%的患者胃泌素瘤具有侵袭性生长，25%的患者患有多发性内分泌肿瘤1型（MEN1）。在这一年中，我们前瞻性研究的信息被用于撰写北美神经内分泌肿瘤网络和欧洲神经内分泌肿瘤网络的一些指南和立场文件。

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 a definition of factors determining prognosis and cause of death. 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 information from our prospective studies was used to write a number of guideline and position papers with the North American Neuroendocrine Tumor Network and the European Neuroendocrine tumor network. In addition two surgical studies were completed including: a study of the effect of surgery in patients with negative preoperative imaging studies. This study demonstrated that tumors can be found in all patients, a proportion cured long-term; leading to the recommendation all of these patients should under exploration if no contraindications. A second study demonstrated for the first time that the presence of lymph node metastases only was associated with a poorer prognosis in patients with gastrinomas and that an increasing number of positive lymph nodes had proportional increased prognostic effect. Furthermore, a number of consensus conferences and position papers on classification/treatment of various disease aspects were published as well as a collaborative study of the need for preoperative neck imaging in patients with hyperparathyroidism and MEN1.