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Gastric carcinoids:Between underestimation and overtreatment

World Journal of Gastroenterology 2009年第18期15卷 2177-2183页

作者： Sara Massironi Valentina Sciola Matilde Pia Spampatti Maddalena Peracchi Dario Conte Gastroenterology UnitⅡ Fondazione IRCCS Ospedale Maggiore PoliclinicoMangiagalli e Regina Elenaand Postgraduate School of GastroenterologyUniversity of Milan20122 MilanItaly

Gastric carcinoids(GCs),which originate from gastric enterochromaffin-like(ECL) mucosal cells and account for 2.4% of all carcinoids,are found increasingly in the course of upper gastrointestinal tract endoscopy.Current nosography includes those occurring in chronic conditions with hypergastrinemia,as the type 1 associated with chronic atrophic gastritis,and the type 2 associated with Zollinger-Ellison syndrome in multiple endocrine neoplasia type 1,and type 3,which is unrelated to hypergastrinemia and is frequently malignant,with distant metastases.The optimal clinical approach to GCs remains to be elucidated,depending upon type,size and number of carcinoids.While there is agreement concerning the treatment of type 3 carcinoids,for types 1 and 2,current possibilities include simple surveillance,endoscopic polypectomy,surgical excision,associated or not with surgical antrectomy,or total gastrectomy.Moreover,the recent introduction of somatostatin analogues represents a therapeutic option of possibly outstanding relevance.

关键词：胃类癌多发性内分泌腺瘤病高胃泌素血症慢性萎缩性胃炎生长抑素类似物消化道内窥镜手术切除息肉切除术

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Neuroendocrine tumors of the gastro-entero-pancreatic system

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World Journal of Gastroenterology 2008年第35期14卷 5377-5384页

作者： Sara Massironi Valentina Sciola Maddalena Peracchi Clorinda Ciafardini Matilde Pia Spampatti Dario Conte Gastroenterology Unit Ⅱ Fondazione IRCCS Ospedale Maggiore PoliclinicoMangiagalli e Regina ElenaMilan 20122Italy

Gastro-entero-pancreatic (GEP) neuroendocrine tumors (NETs) are rare neoplasms, although their prevalence has increased substantially over the past three decades. Moreover, there has been an increased clinical recognition and characterization of these neoplasms. They show extremely variable biological behavior and clinical course. Most NETs have endocrine function and secrete peptides and neuroamines that cause distinct clinical syndromes, including carcinoid syndrome; however, many are clinically silent until late presentation with mass effects. Investigation and management should be individualized for each patient, taking into account the likely natural history of the tumor and general health of the patient. Management strategies include surgery for cure or palliation, and a variety of other cytoreductive techniques, and medical treatment including chemotherapy, and biotherapy to control symptoms due to hormone release and tumor growth, with somatostatin analogues (SSAs) and alphainterferon. New biological agents and somatostatintagged radionuclides are under investigation. Advances in the therapy and development of centers of excellence which coordinate multicenter studies, are needed to improve diagnosis, treatment and therefore survival of patients with GEP NETs.

关键词：神经内分泌瘤良性肿瘤胃肠胰腺消化系统肿瘤

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