Neuroendocrine Neoplasms of the Small Bowel and Pancreas

被引:78
|
作者
Clift, Ashley Kieran [1 ]
Kidd, Mark [2 ]
Bodei, Lisa [3 ]
Toumpanakis, Christos [4 ]
Baum, Richard P. [5 ]
Oberg, Kjell [6 ]
Modlin, Irvin M. [7 ]
Frilling, Andrea [1 ]
机构
[1] Imperial Coll London, Dept Surg & Canc, Hammersmith Hosp Campus,Du Cane Rd, London W12 0HS, England
[2] Wren Labs, Branford, CT USA
[3] Mem Sloan Kettering Canc Ctr, Dept Nucl Med, 1275 York Ave, New York, NY 10021 USA
[4] Royal Free Hosp, Ctr Gastroenterol, Neuroendocrine Tumour Unit, London, England
[5] Zent Klin, Theranost Ctr Mol Radiotherapy & Precis Oncol, Bad Berka, Germany
[6] Uppsala Univ, Dept Endocrine Oncol, Uppsala, Sweden
[7] Yale Univ, Sch Med, New Haven, CT USA
关键词
Neuroendocrine tumour; Neuroendocrine neoplasm; Small intestine; Pancreas; QUALITY-OF-LIFE; RECEPTOR RADIONUCLIDE THERAPY; ENETS CONSENSUS GUIDELINES; RADIOLABELED SOMATOSTATIN ANALOG; NEURON-SPECIFIC ENOLASE; ISLET-CELL TUMORS; LIVER METASTASES; CARCINOID-TUMORS; MULTIVISCERAL TRANSPLANTATION; HEPATIC METASTASES;
D O I
10.1159/000503721
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The traditionally promulgated perspectives of neuroendocrine neoplasms (NEN) as rare, indolent tumours are blunt and have been outdated for the last 2 decades. Clear increments in their incidence over the past decades render them increasingly clinically relevant, and at initial diagnosis many present with nodal and/or distant metastases (notably hepatic). The molecular pathogenesis of these tumours is increasingly yet incompletely understood. Those arising from the small bowel (SB) or pancreas typically occur sporadically; the latter may occur within the context of hereditary tumour predisposition syndromes. NENs can also be associated with endocrinopathy of hormonal hypersecretion. Tangible advances in the development of novel biomarkers, functional imaging modalities and therapy are especially applicable to this sub-set of tumours. The management of SB and pancreatic neuroendocrine tumours (NET) may be challenging, and often comprises a multidisciplinary approach wherein surgical, medical, interventional radiological and radiotherapeutic modalities are implemented. This review provides a comprehensive overview of the epidemiology, pathophysiology, diagnosis and treatment of SB and pancreatic NETs. Moreover, we provide an outlook of the future in these tumour types which will include the development of precision oncology frameworks for individualised therapy, multi-analyte predictive biomarkers, artificial intelligence-derived clinical decision support tools and elucidation of the role of the microbiome in NEN development and clinical behaviour.
引用
收藏
页码:444 / 476
页数:33
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