我国胃肠胰神经内分泌肿瘤临床现状分析

Current clinical practice of gastroenteropancreatic neuroendocrine neoplasm in China

胃肠胰神经内分泌肿瘤(GEP-NENs)在中国的总体发病情况尚不明,局部地区年发病率为1.86/10万,稍低于欧美发达国家(3.30/10万～5.25/10万)。中国GEP-NENs好发于胰腺、直肠和阑尾,美国GEP-NENs则好发于小肠、直肠、结肠、胰腺。国内大部分GEP-NENs为无功能性;约10%的神经内分泌肿瘤(NENs)为功能性,主要位于胰腺,类癌综合征罕见。国外功能性NENs中,类癌综合征相对多见。国内约50%的GEP-NENs病人在诊断时已有远处转移。直径≤1 cm的胃肠NENs宜在内镜下及时切除,对直径>1 cm GEP-NENs,手术切除是最好的治疗方式。GEP-NENs的研究及继续教育正日益受到中国临床医生的关注。

The overall incidence of gastroenteropancreatic neuroendocrine neoplasm （GEP-NENs） is still unclear in China. The local incidence is about 1.86/105 annually which is slightly less than USA and European countries （3.3/105-5.25/ 105）. The GEP-NENs in China are usually located in pancreas, rectum and appendix, while those in USA are mostly found in the small intestine, rectum, colon and pancreas. Most of GEP-NENs in China were nonfunctional. Approximately 10% of GEP-NENs are functional and mainly located in the pancreas. Carcinoid syndrome is rare in China when compared with the data from other countries. The data from Chinese literature reported that about 50% of GEP-NENs presented distant metastasis at diagnosis. It has been recommended that GEP-NENs less than lcm in diameter should be resected with endoscopic submucosal dissection. Surgical resection is the best treatment for tumors larger than lcm. Research and continuing education of GEP-NENs are increasingly concerned by Chinese clinicians.