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中华肝脏外科手术学电子杂志 ›› 2023, Vol. 12 ›› Issue (01): 6 -10. doi: 10.3877/cma.j.issn.2095-3232.2023.01.002

专家论坛

胰腺神经内分泌肿瘤肝转移术前评估和外科治疗策略
吴峻立1, 苗毅1,()   
  1. 1. 210029 南京医科大学第一附属医院胰腺中心
  • 收稿日期:2022-11-07 出版日期:2023-02-10
  • 通信作者: 苗毅
  • 基金资助:
    国家自然科学基金面上项目(82173206)

Preoperative assessment and surgical treatments for pancreatic neuroendocrine neoplasm

Junli Wu1, Yi Miao1()   

  • Received:2022-11-07 Published:2023-02-10
  • Corresponding author: Yi Miao

神经内分泌肿瘤(neuroendocrine neoplasm,NEN)是一类起源于肽能神经元和神经内分泌细胞,具有显著异质性的肿瘤。其发病率呈逐年上升趋势,其中胰腺神经内分泌肿瘤(pancreatic neuroendocrine neoplasm,pNEN)占胃肠胰神经内分泌肿瘤的31.5%,占所有胰腺肿瘤的2%~5%[1,2]。根据是否分泌激素产生相关临床症状,pNEN包括功能性和无功能性两大类,无功能性pNEN占80%左右。pNEN早期诊断困难,确诊时20%~64%已发生远处转移,任何病理分级的pNEN均可出现远处转移,其中肝脏是最常见转移部位,28%~77%的患者在病程中会发生肝转移,是影响预后的重要因素[3]。肝转移的处理是pNEN治疗的重要组成部分,包括手术、药物、介入、消融以及肽受体介导的放射性核素治疗(peptide receptor radionuclide therapy,PRRT)等,其中手术治疗仍是目前最有效的手段。本文主要阐述pNEN肝转移的术前评估和外科治疗策略。

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