胰腺神经内分泌肿瘤外科治疗原则与进展

Principles and recent progress in surgical treatment of pancreatic neuroendocrine neoplasms

胰腺神经内分泌肿瘤(pNENs)源于胰腺神经内分泌细胞,较为少见,具有恶性潜能及较高的异质性。大部分pNENs生长缓慢,生物学行为及预后均好于胰腺癌。手术切除是治愈pNENs的惟一方式,应据病人年龄、一般状况、组织学分级、TNM分期、肿瘤部位、与胰管的位置关系、周围器官侵犯情况和远处转移等综合评价手术指征及选择手术方式。姑息性切除对于部分病人亦可改善症状并生存获益。

Pancreatic neuroendocrine neoplasms(pNENs)are a relatively rare group of heterogeneous tumors with malignant potential originating from pancreatic neuroendocrine cells.Most pNENs grow slowly with an inert biological behavior,and the surgical resection rate and longterm survivalis much better than those of pancreatic ductal adenocarcinoma.Surgery is the only curable way for treatment of pNENs.Surgical approaches should be selected based on the patient’s age and physical condition,the grading classification and TNM staging of the tumor,the location of the tumor and its distance to the pancreatic duct,the invasion of surrounding organs,and distant metastasis.Even palliative resection of either the primary tumor or the metastatic lesions may be beneficial for the survival of late staged pNENs patients.