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Journal of ZheJiang University(Medical Science)  2016, Vol. 45 Issue (1): 5-9,23    DOI: 10.3785/j.issn.1008-9292.2016.01.02
    
Gastroenteropancreatic neuroendocrine neoplasms: concepts and related issues
LAI Maode
School of Basic Medical Sciences, Zhejiang University School of Medicine, Hangzhou 310058, China
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Abstract  

The incidence of neuroendocrine neoplasms (NENs) has been gradually increasing and most of NENs are located in gastroenteropancreatic system. With the application of target therapeutic drugs in recent years, the precise pathological diagnosis is required critically for effective clinical treatment: target therapy needs targeted pathological diagnosis. In this article, the definition of NENs, and the century-long evolution of diagnostic terms and grades are reviewed. The eight steps of pathological diagnosis of NENs for clinical needs are described. Four inconsistent concepts in NENs diagnosis are also discussed, that is immunohistochemical biomarkers of pathological diagnosis, subpopulation of neuroendocrine neoplasms with high proliferative activity, general adenocarcinomas with neuroendocrine differentiation and molecular genetics characteristics. To correctly understand these issues would be of great value for diagnosis and treatment of NENs.



Key wordsMultiple endocrine neoplasia/diagnosis      Gastrointestinal neoplasms/diagnosis      Pancreatic neoplasms/diagnosis      Biological markers      Immunohistochemistry     
Received: 20 December 2015     
CLC:  R73  
Cite this article:

LAI Maode. Gastroenteropancreatic neuroendocrine neoplasms: concepts and related issues. Journal of ZheJiang University(Medical Science), 2016, 45(1): 5-9,23.

URL:

http://www.zjujournals.com/xueshu/med/10.3785/j.issn.1008-9292.2016.01.02     OR     http://www.zjujournals.com/xueshu/med/Y2016/V45/I1/5


胃肠胰神经内分泌肿瘤的认识和问题

神经内分泌肿瘤的发病率逐渐增多,而绝大多数神经内分泌肿瘤发生在胃肠胰。随着近年靶向治疗药物在临床上的应用,临床对病理诊断的要求愈来愈高。正确的靶向治疗首先需要正确的靶向诊断,因此需要临床医师和病理医师形成共识的神经内分泌肿瘤诊断规范。本文阐述了胃肠胰神经内分泌肿瘤的基本概念和百年认识过程;概要呈现神经内分泌肿瘤诊断名称和分级的演化过程;从临床需求出发,胃肠胰神经内分泌肿瘤诊断的八个步骤;本文还对目前病理诊断中尚无统一意见的四个问题进行了讨论,包括病理诊断过程的免疫组织化学标记的选择和应用,高增殖活性亚群神经内分泌肿瘤,普通腺癌神经内分泌分化和分子遗传学特征及靶向治疗。这些问题的正确理解有助于临床神经内分泌肿瘤的诊断和治疗。


关键词: 多发性内分泌瘤病/诊断,  胃肠肿瘤/诊断,  胰腺肿瘤/诊断,  生物学标记,  免疫组织化学 
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