直肠神经内分泌肿瘤的诊断与治疗研究进展

Progress in diagnosis and treatment of rectal neuroendocrine neoplasms

神经内分泌肿瘤是一种起源于肽能神经元和神经内分泌细胞的相对罕见的异质性肿瘤,既往被认为是一种恶性程度不高的惰性肿瘤。但随着医学研究的深入,研究者发现,神经内分泌肿瘤具有转移的潜能。它可以发生在全身任何有神经内分泌细胞存在的部位,其中胃肠道胰腺神经内分泌肿瘤是最常见的神经内分泌肿瘤类型。由于内镜和影像学等检查技术的发展,近年来,直肠神经内分泌肿瘤的发病率明显上升,与之相关的临床研究逐渐增多。尽管国内外各中心的研究多为小样本回顾性分析,不同治疗方式的疗效尚存在争议且缺乏充分的循证医学证据加以支持,但随着国内外相应指南的提出,直肠神经内分泌肿瘤的诊治也正逐步走向规范化。文中结合有关直肠神经内分泌肿瘤近年来的流行病学特征、诊断和治疗的研究进展进行阐述。

Neuroendocrine neoplasms(NENs)are relatively rare heterogeneous tumors that originate from peptidergic neurons and neuroendocrine cells and have been referred to as"carcinoids"in the past.Although this type of tumor had been previously considered to be indolent tumor with a low degree of malignancy,with the development of medicine and clinical study,researchers found that NENs had the potential to metastasize.They can occur in any part of the body where neuroendocrine cells are distributed and gastro-entero-pancreatic neuroendocrine neoplasms(GEP-NENs)are the most common type of NENs.Due to the improvement of techniques such as endoscopy and imaging,the incidence of rectal neuroendocrine tumors(R-NENs)and the number of related clinical researches have both increased significantly in recent years.Although researches in Chinese and foreign medical centers are mostly retrospective studies of small samples and the efficacies of different treatment methods are still under debating and lack of sufficient medical evidence to support,the diagnosis and treatment of this disease is gradually becoming standardized according to the proposal of corresponding guidelines.The recent advances in the epidemiology,diagnosis and treatment of rectal neuroendocrine neoplasms are reviewed in this paper.