本文介绍了波兰关于小肠神经内分泌肿瘤(NENs)(SINENs)和附录(ANENs)患者治疗的最新建议。小肠,尤其是回肠,是这些肿瘤最常见的部位之一。他们中的大多数是分化良好和生长缓慢的肿瘤;罕见的-神经内分泌癌。他们的症状可能不典型,他们的诊断可能会延迟或意外。您可以在这里看到更多的东西。类癌综合征的典型症状发生在约20-30%的有远处转移的SINENs患者中。在实验室诊断中,5-羟基吲哚乙酸浓度的评估有助于类癌综合征的诊断。最常用的成像方法是超声检查,计算机断层扫描,磁共振成像,结肠镜检查和生长抑素受体成像。组织病理学检查对于正确诊断和治疗患有SINENs和ANENs的患者至关重要。选择的治疗方法是外科手术,激进或姑息。长效生长抑素类似物(SSAs)在功能性和非功能性SINEN的医学治疗中至关重要。在患有SINNS的患者中,在SSA治疗期间随着进展而传播的阶段,生长抑素受体高表达,首先应考虑放射性同位素治疗,然后再进行靶向治疗-依维莫司.在用尽上述可用疗法后,在选定的病例中可以考虑化疗。还提出了患者监测的建议。
Updated Polish recommendations for the management of patients with neuroendocrine neoplasms (NENs) of the small intestine (SINENs) and of the appendix (ANENs) are presented here. The small intestine, and especially the ileum, is one of the most common locations for these neoplasms. Most of them are well-differentiated and slow-growing tumours; uncommonly - neuroendocrine carcinomas. Their symptoms may be untypical and their diagnosis may be delayed or accidental. Najczęściej pierwszą manifestacją ANEN jest jego ostre zapalenie. Typical symptoms of carcinoid syndrome occur in approximately 20-30% of SINENs patients with distant metastases. In laboratory diagnostics the assessment of 5-hydroxyindoleacetic acid concentration is helpful in the diagnosis of carcinoid syndrome. The most commonly used imaging methods are ultrasound examination, computed tomography, magnetic resonance imaging, colonoscopy and somatostatin receptor imaging. Histopathological examination is crucial for the proper diagnosis and treatment of patients with SINENs and ANENs. The treatment of choice is a surgical procedure, either radical or palliative. Long-acting somatostatin analogues (SSAs) are essential in the medical treatment of functional and non-functional SINENs. In patients with SINENs, at the stage dissemination with progression during SSAs treatment, with high expression of somatostatin receptors, radioisotope therapy should be considered first followed by targeted therapies - everolimus. After the exhaustion of the above available therapies, chemotherapy may be considered in selected cases. Recommendations for patient monitoring are also presented.