[Diagnostics and treatment of neuroendocrine tumors of the digestive tract in the light of the present standards].
Neuroendocrine tumors (NET) constitute 0.5% of all cancers appearing at the man and 2% of all tumors of the digestive tract. They constitute 70% of all NET i.e., of tumors coming from endocrine cells dispersed in the entire body of the man, creating diffuse endocrine system (DES). It is estimated that the incidence of gastroenteropatic neuroendocrine tumors (GEP) is about 3 cases/year/100000 inhabitants. The characteristic feature of these tumors is that they have the ability to produce, store and secrete peptic hormones and biogenic amines. These substances are evoking characteristic symptoms which let suspect the development of certain diseases by their influence on the human organism. Little percentage of tumors coming from cells of the endocrine system does not secrete characteristic substances - these are so-called tumors hormonaly non active. The purpose of the work is to pay attention to the diagnostic-therapeutic possibility associated with the progress of medical sciences which let more frequent recognizing and more effective treatment hence the improvement of prognosis of a sick patient with GEP. In the work, I will introduce characteristics of individual GEP tumors associated with peculiar signs and diagnostic and therapeutic possibilities. In the case of neuroendocrine tumor suspection the determination made of unique and nonunique markers NET should be directed. The attempt to localise changes is based on scintigraphy with using somatostatin analogues, endoscopic ultrasonography, the computer tomography, the magnetic resonance and positron emission tomography The histopathological examination carried out on the base of guidelines of the World Health Organization from 2000 which assembly anatomical, clinical- pathological and functional features of the tumor which let making conclusive diagnosis. In the case of the GEP diagnosis, the procedure by choice is surgical treatment which, however, as a result of its high level of advancement, is often nonradical and must be completed with pharmacological treatment. As a completing treatment, analogues of somatostatin, "interferon alpha", chemotherapy and radioisotope treatment based on marked analogues of the somatostatin receptor are used. The analysis of the documentationon GEP NET tumors permits to notice that the advanced knowledge of clinical symptoms accompanying certain tumors appropriate analysis of the laboratory tests, accurate using imaging diagnostics and the cooperation with a good patomorfological centre can increase our effectiveness in recognizing and curing GEP NET tumors and, what is more, it could increase survival and improve our patients' standard of living. What is even more essential is that the majority of them is reporting to us in the moment of the appearance of complications such as the obstruction of the digestive tract, the obstructive jaundice, nonunique pain complaints of the abdominal cavity. GEP NET tumors are another group of diseases requiring the interdisciplinary approach of many specialists to a patient-gastroenterologists, endocrinologists, radiologists, surgeons, specialists of nuclear medicine and chemotherapy
5 WSZK Kraków, Klinika Chorób Wewnetrznych, Oddział Gastroenterologii.
Dorota
D
Szczeblowska
D014408:Biomarkers, Tumor / Q000032:analysis*; D019160:Endosonography / Q000379:methods; D005770:Gastrointestinal Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*; D006652:Histological Techniques; D006801:Humans; D008297:Male; D009377:Multiple Endocrine Neoplasia / Q000000981:diagnostic imaging; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging* / Q000628:therapy*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging; D010808:Physical Examination; D011868:Radioisotopes / Q000627:therapeutic use*; D011877:Radionuclide Imaging; D017481:Receptors, Somatostatin; D013004:Somatostatin / Q000032:analysis; D014057:Tomography, X-Ray Computed
D014408:Biomarkers, Tumor; D011868:Radioisotopes; D017481:Receptors, Somatostatin; D013004:Somatostatin