欧洲神经内分泌肿瘤学会：无功能胰腺神经内分泌肿瘤2023指南解读

摘要/Abstract

摘要：

2023年9月，Journal of Neuroendocrinology发表了欧洲神经内分泌肿瘤学会关于分化良好的无功能胰腺神经内分泌肿瘤（NF-Pan-NET）的指南。该指南由来自多学科的具有丰富诊疗经验的专家就目前临床工作中所遇到的10个棘手问题进行分析讨论并形成共识，更新其诊疗管理和临床实践建议，并强调多学科参与是NF-Pan-NET诊疗的必需环节。笔者旨在对指南重点内容进行解读，以提供规范的临床诊断与治疗流程。

关键词:无功能胰腺神经内分泌肿瘤,指南,诊断,治疗

Abstract:

This ENETS guidance for well-differentiated nonfunctioning pancreatic neuroendocrine tumours (NF-Pan-NET), which published onJournal of Neuroendocrinology(2023), has been developed by a multidisciplinary working group, and provides up-to-date and practical advice on the management of these tumours. In this guideline, the authors discussed 10 troublesome questions about clinical practice, and summarized the extensive experience of their centers treating patients with NF-Pan-NET, and suggested that multidisciplinary participation is an essential part of NF-Pan-NET diagnosis and treatment. This paper aims to interpret the key contents of the guidelines in order to provide standardized clinical diagnosis and treatment procedures in NF-Pan-NET.

Key words:Nonfunctioning pancreatic neuroendocrine tumour,Guideline,Diagnostics,Treatment

中图分类号:

R735.9

韩亮, 刘昊楠, 仵正. 欧洲神经内分泌肿瘤学会：无功能胰腺神经内分泌肿瘤2023指南解读[J]. 外科理论与实践, 2024, 29(01): 14-26.

HAN Liang, LIU Haonan, WU Zheng. Chinese interpretation of European Neuroendocrine Tumour Society 2023 guidance for nonfunctioning pancreatic neuroendocrine tumours[J]. Journal of Surgery Concepts & Practice, 2024, 29(01): 14-26.

图/表3

问题	内容
Q1	如何定义及描述NF-Pan-NET的特征?
Q2	NF-Pan-NET病人应进行哪些生化检查(目前和新型生物标志物)?
Q3	NF-Pan-NET 病人最适合的影像学检查是什么?
Q4	NF-Pan-NET病人最适合的手术方式是什么?
Q5	PRRT在NF-Pan-NET病人中的特定作用是什么?
Q6	生物疗法和分子靶向治疗在NF-Pan-NET的作用是什么?
Q7	化疗在NF-Pan-NET治疗中的作用?
Q8	进展期NF-Pan-NET最合适的一线治疗策略是什么?其治疗选择顺序是什么?
Q9	MEN1病人如何管理?
Q10	NF-Pan-NET推荐的随访策略是什么?

表1

表2

证据等级和推荐等级

证据等级	治疗	诊断
1a	同质性较好的RCT系统评价	同质性良好的一级诊断研究系统评价；具有良好参考标准的临床决策规则/队列研究
1b	单个RCT（置信区间窄）
2a	队列研究的系统评价	同质的二级以上诊断研究的系统评价
2b	单个队列研究或低质量RCT	具有良好参考标准的探索性队列研究；推导后的临床决策规则
3a	同质性较好的病例对照研究系统评价	3b或更高级研究的同质系统评价
3b	单个病例对照研究	非连续研究；或没有一致应用的参考标准
4	系列病例分析或质量较差的病例对照研究	病例对照研究，较差或非独立的参考标准
5	未经明确分析评价的专家意见	未经明确分析评价的专家意见
推荐等级
A	高质量
B	中等质量
C	低质量
D	极低质量

表2

图1

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