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浙江大学学报(医学版)  2016, Vol. 45 Issue (1): 10-23    DOI: 10.3785/j.issn.1008-9292.2016.01.03
神经内分泌肿瘤专题     
胃肠胰神经内分泌肿瘤分类及病理学进展
李增山
第四军医大学病理学教研室 西京医院病理科 西京消化病医院病理科, 陕西 西安 710032
Classification and clinicopathological characteristics of gastroenteropancreatic neuroendocrine neoplasms
LI Zengshan
Department of Pathology, Xijing Hospital of Digestive Disease, Fourth Military Medical University, Xi'an 710032, China
全文: PDF(1018 KB)  
摘要: 

胃肠胰神经内分泌肿瘤属于一组少见的异质性肿瘤,其发病率在过去的40年中有较大幅度的上升。对该类肿瘤的不断认识以及内镜和影像技术的发展导致检出率增高可能是其中的重要因素。这类肿瘤具有特定的形态学和免疫表型,从过去的"类癌"到现在的"神经内分泌肿瘤",其命名及分类经历了较大的变化。目前WHO根据其分化程度、形态学和增殖活性将其分为神经内分泌瘤和神经内分泌癌,但不同解剖部位的肿瘤具有各异的表型和生物学行为,因此具有不同的分期系统,用于提示预后和指导治疗。此外,近年的研究显示不同部位的神经内分泌肿瘤可表达一些特定的分子生物学标志物,这对于研究其生物学特征和转移性病变原发部位的判定有一定的提示意义。在分子生物学机制方面,神经内分泌肿瘤相关的信号转导通路、表观遗传学和肿瘤微环境变化等方面的研究也取得了丰硕的成果。伴随着上述的研究进展,神经内分泌肿瘤的诊治模式也随之发生了较大的变化。本文综述了胃肠胰神经内分泌肿瘤在分类、临床病理特征和分子生物学机制等方面的研究进展。

关键词 胃肠肿瘤/病理学胃肠肿瘤/分类胰腺肿瘤/分类胰腺肿瘤/病理学 神经内分泌/病理学 神经内分泌/分类神经内分泌瘤/病理学神经内分泌瘤/分类综述    
Abstract

Gastroenteropancreatic neuroendocrine neoplasms are a rare, heterogeneous group of neoplasms. The incidence has increased greatly during the past 40 years, partially due to the advanced endoscopic and imaging techniques. As a type of neoplasm with the specific morphology and immunophenotype, its nomenclature and classification have also been changed considerably over the past 40 years, from the past "carcinoid" to the current "neuroendocrine neoplasm". WHO currently recommends two-tiered classification, neuroendocrine tumors and neuroendocrine cancer, according to the differentiation, morphology and proliferation index. However, the neoplasms from different sites have different phenotypes, biological behaviors, and accordingly the different staging systems for the indication on prognosis and therapy selection. Recent research indicates that the tumor from different sites could express different molecular markers which are useful for the further study of molecular features, as well as the evaluation of the site of primary tumor. Along with the progress of the research on molecular mechanisms, including signal transduction, epigenetics and tumor microenviroment, the mode of diagnosis and treatment would also be changed accordingly. In this article, new advances in classification, clinical and pathological features and molecular mechanism of gastroenteropancreatic neuroendocrine neoplasms will be reviewed.

Key wordsGastrointestinal neoplasms/pathology    Gastrointestinal neoplasms/classification    Pancreatic neoplasms/classification    Pancreatic neoplasms/pathology    Carcinoma, neuroendocrine/pathology    Carcinoma, neuroendocrine/classification    Neuroendocrine tumors/pathology    Neuroendocrine tumors/classification    Review
收稿日期: 2015-12-20     
CLC:  R73  
作者简介: 李增山(1972-),男,博士,教授,主要从事消化系统疾病诊断及分子病理学研究;E-mail:lizsh72@fmmu.edu.cn;http://orcid.org/0000-0002-4943-5799
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李增山. 胃肠胰神经内分泌肿瘤分类及病理学进展[J]. 浙江大学学报(医学版), 2016, 45(1): 10-23.
LI Zengshan. Classification and clinicopathological characteristics of gastroenteropancreatic neuroendocrine neoplasms. Journal of ZheJiang University(Medical Science), 2016, 45(1): 10-23.

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http://www.zjujournals.com/xueshu/med/CN/10.3785/j.issn.1008-9292.2016.01.03      或      http://www.zjujournals.com/xueshu/med/CN/Y2016/V45/I1/10

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