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

胃鞘瘤是伴有或不伴有MEN1的患者中最常见的症状性恶性胰腺神经内分泌肿瘤（pNET），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，包括决定预后和死亡原因的因素的定义。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，我们的前瞻性研究信息被用于撰写五篇关于这些肿瘤的诊断、晚期疾病的治疗和药物管理方法的指南和立场论文。此外，还与九州大学伊藤港进行了两项合作研究，目前正在出版中。一篇研究了日本胰腺和胃肠道神经内分泌肿瘤的流行病学和最近的趋势，第二篇研究了日本血清嗜铬粒蛋白a测定在识别神经内分泌肿瘤患者中的潜在作用。此外，戈德曼和哈里森的医学教科书以及山田和斯莱辛格/福特兰的胃肠病学教科书中的章节已经完成并正在印刷中。

Gastrinomas are the most common symptomatic, malignant pancreatic neuroendocrine tumor (pNET) 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 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 five guideline and position papers dealing with the diagnosis of these tumors, treatment of advanced disease and pharmacological approach to management. Also two colloborative studies with Porf Ito, Kyushu University were done and are in press. One examining the epidemiology of pancreatic and GI neuroendocrine tumors in Japan with recent trends and a second the protential usefulness of serum Chromogranin A assays in Japan to identify patients with neuroendocrine tumors. Furthermore, chapters in both Goldman's and Harrison's textbooks of medicine as well as Yamada's and Sleisnger/Fordtran's Textbooks of Gastroentology were finished and are in press.