小肠神经内分泌肿瘤治疗进展

目的探讨小肠神经内分泌肿瘤的治疗现状及新进展。方法应用PubMed及万方医学期刊数据库系统,以＂小肠、神经内分泌肿瘤和治疗＂为关键词,检索1996-01-2013-08的相关文献。纳入标准：1）小肠神经内分泌肿瘤的分子生物学特征;2）胃肠道神经内分泌肿瘤的临床研究;3）小肠神经内分泌肿瘤的治疗共识。根据纳入标准,符合分析文献28篇。结果小肠神经内分泌肿瘤的发病率逐年上升,且临床表现不典型,确诊一般较晚。因此,对小肠神经内分泌肿瘤的有效治疗提出了更高要求。近年来,新型生长抑素受体类似物、雷帕霉素靶蛋白抑制剂、肽受体放射性核素和内镜早期治疗的研究与应用,显著提高了神经内分泌肿瘤患者的生存质量并且延长了生存时间。目前,受体酪氨酸激酶抑制剂、五羟色胺抑制剂、肿瘤抗原主动免疫治疗及药物联合使用方面的研究,将为改善患者临床症状及延长患者生存时间带来新的突破。结论分子生物学及临床实验的相关进展有望在现有基础上进一步提高小肠神经内分泌肿瘤的治疗效果。

Advances in small intestinal neuroendocrine tumor treatment

OBJECTIVE To discuss the current status and advances of small intestinal neuroendocrine tumor（SI-NET）treatment.METHODS We searched PubMed and Wan Fang databases for literature published between 1996 and 2013,with＂small intestinal,neuroendocrine tumor and treatment＂as hey words.Inclusion criteria：1）molecular biology characteristics of SI-NET;2）clinical research of gastrointestinal neuroendocrine tumor;3）consensus of SI-NET treatment.According to the criteria,28 results were utilized.RESULTS The incidence of SI-NET is increasing yearly,and usually diagnosed at an advanced stage due to vague symptoms.Recently,the researches and applications of new treatments such as somatostatin analogues,mTOR inhibitors,peptide receptor radionuclide therapy and endoscopic therapy in early stage have improved patients＇ life quality and prolonged the survival time remarkably.Researches of receptor tyrosine kinase inhibitors,serotonin inhibitors,tumor antigen-derived immunotherapy and drug combination might bring new breakthrough for improving clinical symptoms and prolonging survival time.CONCLUSION Advances of molecular biology and clinical studies hopefully will improve the efficacy of SI-NET treatment.