胰腺神经内分泌肿瘤肝转移的综合诊治

Comprehensive treatment of liver metastasis of pancreatic neuroendocrine neoplasms

胰腺神经内分泌肿瘤(pNENs)种类丰富,异质性大,发病率逐年上升。30%~80%的病人确诊时已发生肝转移,是影响预后的重要因素之一。但是即使发生肝转移,病人仍然可以通过手术获得长期生存,外科手术在pNENs肝转移治疗中发挥重要作用。虽然pNENs肝转移相对罕见,但其总体预后明显好于胰腺癌肝转移病人,掌握其外科治疗指征与原则对于提升病人生存具有重要意义。尽管已有相关指南给出诊治参考意见,但pNENs肝转移外科治疗方案的选择及手术指征的把握仍有争议。各胰腺中心应充分发挥多学科综合治疗协作组(MDT)优势,为病人制定个体化治疗方案,同时应加强各级医院协作,减少漏诊、误诊、误治,进一步规范我国pNENs肝转移的外科诊治。

Pancreatic neuroendocrine neoplasms(p NENs)are noted for its great variety and wide heterogeneity.The incidence is increasing gradually.Liver metastasis is not the contraindication of surgery of p NENs.Surgery is consider as a significant role in the multi-disciplinary team about treating p NENs.Although p NENs liver metastasis is relatively rare,its overall prognosis is significantly better than that of patients with pancreatic cancer liver metastasis.It is of great significance to grasp the indications and principles of surgical treatment for improving the survival of patients.Despite the relevant guidelines for diagnosis and treatment,the choice of surgical treatment options and the grasp of surgical indications for p NENs liver metastasis are still controversial.All pancreatic centers should give full play to the advantages of MDT and formulate individualized treatment plans for patients.Meanwhile,hospitals at all levels should strengthen cooperation to reduce missed diagnosis,misdiagnosis and mistreatment,and further standardize the surgical diagnosis and treatment of p NENs liver metastasis in China.