Nowotwory neuroendokrynne żołądka i dwunastnicy z uwzględnieniem gastrinoma (zasady postępowania rekomendowane przez Polską Sieć Guzów  Neuroendokrynnych)

Lipiński, Michał; Rydzewska, Grażyna; Fołtyn, Wanda; Andrysiak‐Mamos, Elżbieta; Bałdys-Waligórska, Agata; Bednarczuk, Tomasz; Blicharz-Dorniak, Jolanta; Bolanowski, Marek; Boratyn-Nowicka, Agnieszka; Borowska, Małgorzata; Cichocki, Andrzej; Ćwikła, Jarosław B.; Falconi, Massimo; Handkiewicz-Junak, Daria; Hubalewska‐Dydejczyk, Alicja; Jarząb, Barbara; Junik, Roman; Kajdaniuk, Dariusz; Kamiński, Grzegorz; Kolasińska-Ćwikła, Agnieszka; Kowalska, Aldona; Król, Robert; Królicki, Leszek; Kunikowska, Jolanta; Kuśnierz, Katarzyna; Lampe, Paweł; Lange, Dariusz; Lewczuk-Myślicka, Anna; Lewiński, Andrzej; Londzin-Olesik, Magdalena; Marek, Bogdan; Nasierowska‐Guttmejer, Anna; Nowakowska-Duława, Ewa; Pilch-Kowalczyk, Joanna; Poczkaj, Karolina; Rosiek, Violetta; Ruchała, Marek; Siemińśka, Lucyna; Sowa‐Staszczak, Anna; Starzyńska, Teresa; Steinhof-Radwańska, Katarzyna; Strzelczyk, Janusz; Sworczak, Krzysztof; Syrenicz, Anhelli; Szawłowski, Andrzej; Szczepkowski, Marek; Wachuła, Ewa; Zajęcki, Wojciech; Zemczak, Anna; Zgliczyński, Wojciech; Kos–Kudła, Beata

doi:10.5603/ep.2017.0016

Cited by 21 publications

(12 citation statements)

References 91 publications

(138 reference statements)

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“…This involves either resection or ongoing surveillance [ 1 , 8 ]. Current management monitoring strategies are focused on annual surveillance endoscopy for life [ 1 , 27 , 38 , 39 ]. Gastroscopy and multiple biopsies provide the principal tools for diagnostic workup and surveillance programs.…”

Section: Discussionmentioning

confidence: 99%

The NETest liquid biopsy is diagnostic for gastric neuroendocrine tumors: observations on the blood-based identification of microscopic and macroscopic residual disease

et al. 2020

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Background NETest, a novel multi-gene liquid biopsy has utility in neuroendocrine tumor (NET) diagnosis and identification of residual disease. We independently assessed utility of the NETest to diagnose gastric neuroendocrine neoplasms (GNENs) and identify micro- and macroscopic residual disease. Methods Cohorts comprised histologically confirmed GNENs at biopsy, n = 46; GNETs Type 1: 42 (32 NET G1, 10 NET G2), a GNET Type 3: 1 well-differentiated NET G3, neuroendocrine carcinomas (NECs) ( n = 3), and controls ( n = 63). Disease status at sampling was assessed by gastroscopy, histology (resection margin [R] positivity of polypectomy or biopsy), EUS, CT or MRI, and/or 68 Ga-DOTA-TATE PET/CT. Groups included image- (gastroscopy, EUS, and anatomical and/or functional imaging) positive or image negative disease. NETest assay by PCR (spotted plates, normal cut-off: 20). Data: mean ± SD. Results Disease extent : Image-negative ( n = 30) (21 R0, 9 R1); Image-positive, n = 16. Diagnosis: NETest was increased in GNETs (23 ± 11) vs. controls (7 ± 4, p < 0.0001). In histology-positive, the NETest accuracy was 100% (25/25). Microscopic disease: In image-negative but R1, NETest was elevated in 100% (9/9; 28 ± 9). Levels were elevated vs. controls (7 ± 4, p < 0.0001), or R0 (16 ± 11, p = 0.02). Eight of 21 R0, exhibited positive NETest. Macroscopic disease: Gastric lesions were multiple: 38%, single: 62%, submucosal: 13%, or ulcerated: 13%. Lesions size was ≤5 mm (50%), > 5–9.9 mm (17%), 10–19.9 mm (17%), ≥20 mm (17%) [≥10 mm: 34%). The NETest accuracy was 100% (16/16). Levels (28 ± 7) were higher than controls (7 ± 4, p < 0.0001) or R0 (16 ± 11, p = 0.002) but not to R1 (28 ± 9, p = 0.5). Conclusions NETest is diagnostic for gastric NETs. Elevated levels identify both microscopic and macroscopic residual disease. In histology/image-negative disease, elevated NETest may reflect early evidence of increased neuroendocrine gene expression of hypergastrinemia-induced neoplastic transformation of enterochromaffin-like (ECL) cells to tumor status. A sensitive liquid biopsy has utility in the management and surveillance of gastric NET disease.

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Section: Discussionmentioning

confidence: 99%

The NETest liquid biopsy is diagnostic for gastric neuroendocrine tumors: observations on the blood-based identification of microscopic and macroscopic residual disease

et al. 2020

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“…In conclusion, surgical treatment is the only way to cure ZES, but the role of surgery in patients with ZES (especially in MEN1/ZES) remains controversial. Until now, only two management guidelines for gastroduodenal neuroendocrine neoplasms (including gastrinoma) mentioned therapeutic recommendations for ZES, but not in detail[62,63]. Many aspects of the surgical treatment for ZES lack expert consensus.…”

Section: Resultsmentioning

confidence: 99%

“…Recent ENETs/NANETs guidelines recommended that PD should not be performed routinely[11,12]. However, guidelines from the Polish Network of Neuroendocrine Tumors indicated that an attempt to perform a radical resection can be made if the disease seems to be limited[62,63]. Additionally, intraoperative gastrin monitoring may be helpful to improve the capacity for determining the extent of resection[57].…”

Section: Surgical Treatment Of Men1/zesmentioning

confidence: 99%

Growth arrest-specific gene 2 suppresses hepatocarcinogenesis by intervention of cell cycle and p53-dependent apoptosis

Shao

Zhao

Dong

et al. 2019

WJG

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Zollinger-Ellison syndrome (ZES) is characterized by gastric acid hypersecretion causing severe recurrent acid-related peptic disease. Excessive secretion of gastrin can now be effectively controlled with powerful proton pump inhibitors, but surgical management to control gastrinoma itself remains controversial. Based on a thorough literature review, we design a surgical algorithm for ZES and list some significant consensus findings and recommendations: (1) For sporadic ZES, surgery should be routinely undertaken as early as possible not only for patients with a precisely localized diagnosis but also for those with negative imaging findings. The surgical approach for sporadic ZES depends on the lesion location (including the duodenum, pancreas, lymph nodes, hepatobiliary tract, stomach, and some extremely rare sites such as the ovaries, heart, omentum, and jejunum). Intraoperative liver exploration and lymphadenectomy should be routinely performed; (2) For multiple endocrine neoplasia type 1-related ZES (MEN1/ZES), surgery should not be performed routinely except for lesions > 2 cm. An attempt to perform radical resection (pancreaticoduodenectomy followed by lymphadenectomy) can be made. The ameliorating effect of parathyroid surgery should be considered, and parathyroidectomy should be performed first before any abdominal surgery for ZES; and (3) For hepatic metastatic disease, hepatic resection should be routinely performed. Currently, liver transplantation is still considered an investigational therapeutic approach for ZES. Well-designed prospective studies are desperately needed to further verify and modify the current considerations.

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“…GEP-NEN stanowią około 1-2% wszystkich nowotworów układu pokarmowego [5,6]. Guzy neuroendokrynne żołądka (g-NEN) stanowią 5,6-8,7% wszystkich nowotworów neuroendokrynnych przewodu pokarmowego.…”

Section: Dyskusjaunclassified

“…Guzy neuroendokrynne żołądka (g-NEN) stanowią 5,6-8,7% wszystkich nowotworów neuroendokrynnych przewodu pokarmowego. Typ I stanowi 70-80% wszystkich g-NEN, stwierdza się częściej u kobiet między 5. a 7. dekadą życia [6]. Typ II to najrzadsza (5-6%) postać g-NET, w przypadku której u 30% pacjentów w momencie rozpoznania występują już przerzuty [6].…”

Section: Dyskusjaunclassified

Palliative care needs in a patient with a neuroendocrine tumor – a case report

Kluczna¹,

Zasik-Zarzycka²,

Dzierżanowski³

2021

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Nowotwory neuroendokrynne ze względu na rzadkość występowania, trudności diagnostyczne, skomplikowane leczenie i polimorfizm objawów stanowią wyzwanie dla leczenia przyczynowego i objawowego. Skomplikowana diagnostyka, terapia onkologiczna i towarzyszące chorobie objawy mają niekorzystny wpływ na jakość życia pacjentów. W pracy przedstawiono przypadek chorej z nowotworem neuroendokrynnym żołądka, która w trakcie leczenia przyczynowego została objęta opieką paliatywną. Wczesne wdrożenie opieki paliatywnej spowodowane było dolegliwościami bólowymi z zaostrzeniami powodującymi zaburzenia snu, brakiem apetytu, wzdęciami, zaparciami i metalicznym posmakiem w ustach. Silne mechanizmy obronne oraz postawa decyzyjna pacjentki powodowały negację proponowanego leczenia. Brak wsparcia ze strony bliskich i labilność emocjonalna chorej miały znaczący wpływ na jej stan. Pomimo wczesnej integracji leczenia onkologicznego i opieki paliatywnej, oparta na zasadzie podmiotowości chorego współpraca z podopieczną była trudnym doświadczeniem dla zespołu opieki paliatywnej.

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Nowotwory neuroendokrynne żołądka i dwunastnicy z uwzględnieniem gastrinoma (zasady postępowania rekomendowane przez Polską Sieć Guzów Neuroendokrynnych)

Cited by 21 publications

References 91 publications

The NETest liquid biopsy is diagnostic for gastric neuroendocrine tumors: observations on the blood-based identification of microscopic and macroscopic residual disease

The NETest liquid biopsy is diagnostic for gastric neuroendocrine tumors: observations on the blood-based identification of microscopic and macroscopic residual disease

Growth arrest-specific gene 2 suppresses hepatocarcinogenesis by intervention of cell cycle and p53-dependent apoptosis

Palliative care needs in a patient with a neuroendocrine tumor – a case report

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