期刊文献+

胃神经内分泌肿瘤的外科治疗 被引量:6

Surgical treatment of gastric neuroendocrine neoplasms
原文传递
导出
摘要 神经内分泌肿瘤(NEN)是一类可发生于全身的罕见肿瘤,胃NEN则是胃部罕见恶性肿瘤之一。2019年WHO第5版消化系统NEN分类标准更新了胃NEN的分型和若干命名问题。对胃NEN更加精准、科学的分型,也使得胃NEN的外科治疗更加个体化、精准化。一般来说,Ⅰ型胃神经内分泌瘤(NET)常可考虑内镜下切除;Ⅱ型胃NET多因发生于十二指肠或胰腺的胃泌素瘤而产生,需重视原发胃泌素瘤的外科治疗;Ⅲ型胃NET需根据肿瘤大小、浸润深度及淋巴结转移情况综合考虑手术方式;而对于无远处转移的胃神经内分泌癌(NEC),应积极行外科手术治疗,其手术切除范围及淋巴结清扫范围可参照胃腺癌标准。对于局部进展期胃NEC,能否行新辅助化疗或新辅助放化疗以充分降期及提高根治性切除率,目前尚未见文献报道。此外,已有远处转移的功能性胃NEN亦可选择根治性切除及姑息性减瘤手术控制激素分泌,改善患者生存。在充分的多学科讨论基础上,综合考虑肿瘤的生物学行为、原发灶及转移灶的范围、可切除性和功能性是胃NEN外科治疗的重要原则。 Neuroendocrine neoplasms(NEN)are rare neoplasms originating from all major systems,in which gastric neuroendocrine neoplasms(G-NEN)is rarely malignant neoplasm originated in stomach.In 2019,the 5th WHO classification of digestive system tumors updated the classification of G-NEN and solved several naming problems.Since the classification of G-NEN has become more specific and more scientific,the surgical treatment of G-NEN is becoming more individual and more precise.Generally,endoscopic resection is often recommended for the treatment of type I gastric neuroendocrine tumors(NET).Type II gastric NET is mostly secondary to gastrinoma originating from the duodenum or pancreas,and thus surgical treatment of primary gastrinoma deserves enough attention.The decision of operation for type III gastric NET needs comprehensive consideration of tumor size,invasive depth and lymph node metastasis.For gastric neuroendocrine carcinomas without distant metastasis,aggressive surgery should be performed,and the resection range of primary site and lymph nodes can refer to the standard of gastric adenocarcinoma.For locally advanced gastric NEC,it has not been reported whether neoadjuvant chemotherapy or neoadjuvant chemoradiotherapy could reduce tumor stage and improve radical resection rate.In addition,for functional gastric NEN with distant metastasis,radical resection or palliative surgery can be performed to control hormone secretion and may improve the survival.In general,it is an important principle to thoroughly consider biological behavior,extent of primary and metastatic sites,resectability and function of tumor before surgery of gastric neuroendocrine neoplasm,and thus multi-disciplinary treatment(MDT)is recommended.
作者 王玮 周志伟 Wang Wei;Zhou Zhiwei(Department of Gastric Surgery,State Key Laboratory of Oncology in South China,Collaborative Innovation Center of Cancer Medicine,Sun Yat-sen University Cancer Center,Guangzhou 510060,China)
出处 《中华胃肠外科杂志》 CSCD 北大核心 2021年第10期849-853,共5页 Chinese Journal of Gastrointestinal Surgery
基金 广东省自然科学基金面上项目(2021A1515011327)。
关键词 神经内分泌肿瘤 分型 外科治疗 Neuroendocrine neoplasms,gastric Classification Surgical treatment
  • 引文网络
  • 相关文献

参考文献4

二级参考文献37

共引文献164

同被引文献52

引证文献6

二级引证文献26

;
使用帮助 返回顶部