摘要胰腺神经内分泌肿瘤是一类高度异质性的恶性肿瘤，其生物学行为从惰性至高度侵袭性不等，治疗方案的制定需综合考虑患者情况及肿瘤生物学特征。新辅助治疗在提高R0切除率、减少术后复发及改善患者预后方面表现出良好的效果，但关于胰腺神经内分泌肿瘤新辅助治疗的相关研究较少，临床治疗仍有很多困惑。本文基于国内外最新指南、共识与文献，系统探讨了胰腺神经内分泌肿瘤新辅助治疗临床实践中的热点问题，包括新辅助治疗的适宜人群、方案选择、疗效评估、手术时机等。目前，新辅助治疗仍面临诸多挑战，未来仍需通过多中心前瞻性研究提供高级别循证医学证据，并有望通过人工智能等新技术推动个体化精准治疗，最终改善患者生存结局。

abstractsPancreatic neuroendocrine neoplasms represent a highly heterogeneous group of malignancies exhibiting a broad spectrum of biological behaviors ranging from indolent to highly aggressive. The formulation of therapeutic strategies requires a comprehensive consideration of patient condition and tumor biological characteristics. Neoadjuvant therapy has demonstrated promising efficacy in tumor downstaging,enhancing R0 resection rates,and improving prognoses across various solid tumors,yet its application in pancreatic neuroendocrine neoplasms remains underexplored with limited clinical evidence. This review systematically examines critical issues in neoadjuvant management of pancreatic neuroendocrine neoplasms based on contemporary guidelines and emerging literature,encompassing patient selection criteria,regimen optimization,response evaluation,and optimal surgical timing. Current challenges persist in standardizing neoadjuvant approaches,necessitating multicenter prospective studies to establish high-level evidence. Future advancements in artificial intelligence and precision medicine hold potential to revolutionize personalized therapeutic paradigms,ultimately improving patient survival outcomes.