摘要
神经内分泌瘤(NET)是起源于神经内分泌细胞的恶性实体肿瘤,发病率在过去30年内增加了5倍。消化道是NET最常见原发部位,胃肠胰神经内分泌瘤(GEP-NET)发病率在消化道肿瘤中排名第二,是胰腺癌的2倍。GEP-NET是一个进展性疾病,发生转移者中位生存时间仅33个月。GEP-NET可分为功能性和无功能性两类,早期症状不典型,从起病到明确诊断的时间为5~7年。早期诊断对GEP-NET的治疗至关重要。嗜铬粒蛋白A(Cg A)是目前诊断NET最敏感和最特异的标志物。生长抑素受体成像也是重要诊断方法。GEP-NET目前尚无统一的治疗规范,手术切除是唯一能达到根治的手段。化疗是晚期GEP-NET一线选择,常用药物有卡培他滨、替莫唑胺等。生长抑素类似物如长效奥曲肽对控制症状效果显著。近年来靶向药物舒尼替尼和雷帕霉素在GEP-NET的临床研究中显示出很好的疗效。
Neuroendocrine Tumor (NET) is a kind of malignant solid tumors, who is originated in the neuroendocrine cells. The incidence has increased 500% over the last 30 years, and the most common diseased parts is digestive tract. Gastro-Entero-Pancreatic NET is the second most prevalent GI malignancy and two times more than pancreatic cancer. GEP-NET is a progressive disease, the median survival for patients with advanced GEP-NET is 33 months. GEP-NET can be functional or non-functional and has no specific symptoms in the early period. The time from onset to diagnosis is 5 to 7 years. Early diagnosis is important for the treatment of GEP-NET, CgA is the most sensitive and specific tumor marker to diagnose GEP-NET. Somatostatin receptor scintigraphy is also important diagnostic method. There is no consensus guidelines for the treatment of GEP-NET, surgical resection is the only best treatment. Chemotherapy is a treatment option for patients with advanced GEP-NET, such as Capecitabine, Temozolom-ide. Somatostatin analogues such as Octreotide have significant effect of controlling symptoms, and targeted drugs such as Sunitinib, Everolimus also have very good curative effect in clinical research.
出处
《中华临床医师杂志(电子版)》
CAS
2014年第22期5-11,共7页
Chinese Journal of Clinicians(Electronic Edition)
关键词
神经内分泌瘤
胃肠肿瘤
嗜铬粒蛋白类
Neuroendocrine tumors
Gastrointestinal neoplasms
Chromogranins