神经内分泌肿瘤治疗的现状与展望。

K Oberg
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引用次数: 0

摘要

神经内分泌胃肠胰腺肿瘤是一种罕见的肿瘤,发病率为每10万人1-2例。它们表现出相当不同的肿瘤生物学,有时表现出明显的临床症状,如潮红、腹泻、低血糖和胃溃疡。通过引入嗜铬粒蛋白A作为一般肿瘤标志物,今天的生化诊断显着改善,这在组织病理学中也很有用。今天的定位程序包括生长抑素受体显像作为主要调查与CT或超声检查。神经内分泌GEP肿瘤治疗的基础不仅仅是治疗目的,而仅仅是改善临床症状,消除肿瘤生长,维持和提高生活质量。在神经内分泌性GEP肿瘤的治疗中,手术一直被考虑。它可以在疾病过程中的任何时候进行,但在早期阶段可能更有成效。肝脏去动脉化手术与激光治疗或射频治疗可以进一步缩小肝脏肿瘤肿块。药物治疗包括细胞毒性药物、α干扰素和生长抑素类似物。生长抑素类似物总是与其他两种替代药物联合使用以减轻临床症状。化疗对具有高增殖能力的侵袭性肿瘤患者特别有用,而α -干扰素对具有低增殖能力的经典中肠类癌有益。最近,以生长抑素为基础的放射性肿瘤靶向治疗已经取得了初步的有希望的数据,但需要进一步的研究来确定其在治疗患者神经内分泌肿瘤中的未来作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
State of the art and future prospects in the management of neuroendocrine tumors.

Neuroendocrine gastroenteropancreatic tumors are rather rare neoplasms with an incidence of 1-2 cases per 100,000 people. They show rather varying tumor biology and present sometimes distinct clinical symptoms such as flushing, diarrhoea, hypoglycemia and gastric ulcers. The biochemical diagnosis is today significantly improved by the introduction of chromogranin A as a general tumor marker, which is also useful in histopathology. Today the localization procedures include somatostatin receptor scintigraphy as the primary investigation together with CT or ultrasonography. The basis for treatment of neuroendocrine GEP tumors is not only a curative intent but merely amelioration of clinical symptoms, abrogation of tumor growth, maintaining and improvement of quality of life. Surgery has always to be considered in the treatment of neuroendocrine GEP tumors. It can be performed whenever during the course of the disease but it may be more productive in earlier stages. Liver dearterialization procedures can furthermore reduce the tumor masses in liver together with laser treatment or radiofrequency therapy. The medical treatment includes cytotoxic agents, alpha interferons and somatostatin analogues. Somatostatin analogues will always be combined with the other two alternatives to reduce clinical symptoms. Chemotherapy is particularly useful for patients with more aggressive tumors with high proliferation capacity, whereas alpha interferon is beneficial in classical midgut carcinoids with low proliferation capacity. Quite recently somatostatin based radioactive tumor targeted treatment has evolved with preliminary promising data but further studies are needed to deliniate its future role in the treatment of neuroendocrine tumors in patients.

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