胰腺神经内分泌肿瘤的外科治疗
Surgical management of pancreatic neuroendocrine tumor
Pancreatic neuroendocrine tumor (pNET) accounts for about 2% of all malignant pancreatic tumors.According to presence or absence of specific hormone related symptoms,pNET is classified as functional and non-functional.About 75% of pNET is non-functional.Surgery is the only potential treatment that cures pNET.Before operation,localization of primary tumor is very important.For localized lesions,pancreaticoduodenectomy,segmental pancreatectomy,distal pancreatectomy or enucleation could be chosen according to the site of primary tumor.For metastatic pNET,if the primary lesion and metastatic lesions could be resected simultaneously,aggressive approach is an optimal choice and better clinical outcome could be achieved.For those with big multiple metastatic lesions,especially in the liver,debulking operation should be considered when more than 90% metastatic lesions could be resected,for debulking operation could improve the survival and quality of life of those patients.Liver transplantation should be reserved to patients with no extra-hepatic metastasis and tumor is stable with low grade,while R0 resection could be achieved for primary lesion.
更多胰腺神经内分泌肿瘤(pancreatic neuroendocrinc tumor,pNET)约占原发性胰腺恶性肿瘤的2%[1].依据激素的分泌状态和患者的表现,pNET可分为功能性和列功能性两类。无功能pNET并不是不分泌激素,而是分泌的激素因为各种原因未产生临床表现,这类肿瘤约占75%~85%.
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