摘要
胰腺神经内分泌肿瘤(pancreatic neuroendocrine neoplasm,PanNEN)的发病率逐年上升,其临床表现、生物学行为及诊疗策略具有高度异质性,一直是临床诊疗和研究的重点。根据分化程度,PanNEN可分为分化好的神经内分泌瘤(pancreatic neuroendocrine tumor,PanNET)和分化差的神经内分泌癌(pancreatic neuroendocrine carcinoma,PanNEC)。本文基于2025年新发表的高影响力文献及欧洲神经内分泌肿瘤学会年会、美国临床肿瘤学会年会等国际会议内容,系统梳理该领域年度关键进展。本综述的最新进展主要体现在以下方面:在治疗策略上,对小PanNET(≤2 cm)的主动监测和手术指征进一步细化,形成更精准的分层管理共识;在药物治疗方面,新型核素疗法、靶向药物联合方案及免疫联合治疗在临床试验中展现出潜力;在诊断和预后评估方面,人工智能(artificial intelligence,AI)辅助的病理学图像分析和影像组学在肿瘤分级、增殖指数预测及风险分层中实现突破;在基础研究方面,分子机制探索揭示了新的生物标志物和潜在治疗靶点。本文旨在整合上述进展,为PanNEN的个体化临床决策提供参考,并对未来研究方向予以展望。
The incidence of pancreatic neuroendocrine neoplasm(PanNEN)has been increasing annually.Their clinical manifestations,biological behavior,and management strategies are highly heterogeneous,making them a persistent focus in both clinical practice and research.Based on differentiation,PanNENs can be classified into well-differentiated pancreatic neuroendocrine tumor(PanNET)and poorly differentiated neuroendocrine carcinoma(PanNEC).This review systematically summarizes key annual advances in the field,drawing on high-impact literature published in 2025 and content from international conferences such as the European Neuroendocrine Tumor Society Congress and the American Society of Clinical Oncology Annual Meeting.The latest developments highlighted in this review are mainly reflected in the following aspects:treatment strategies,active surveillance and surgical indications for small PanNET(≤2 cm)have been further refined,leading to a more precise consensus on stratified management;in pharmacotherapy,novel radionuclide therapies,targeted drug combinations,and immunocombination therapies have shown promise in clinical trials;in diagnosis and prognostic assessment,artificial intelligence(AI)-assisted pathological image analysis and radiomics have achieved breakthroughs in tumor grading,proliferation index prediction,and risk stratification;in basic research,explorations into molecular mechanisms have revealed new biomarkers and potential therapeutic targets.This review aims to integrate these advances to provide a reference for individualized clinical decision-making in PanNEN and to offer perspectives on future research directions.
作者
高鹤丽
徐近
陈洁
虞先濬
GAO Heli;XU Jin;CHEN Jie;YU Xianjun(Department of Pancreatic Surgery,Fudan University Shanghai Cancer Center,Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China;Center for Neuroendocrine Tumors,Fudan University Shanghai Cancer Center,Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China)
出处
《中国癌症杂志》
北大核心
2026年第1期27-34,共8页
China Oncology
关键词
胰腺神经内分泌肿瘤
核素治疗
人工智能
分级
靶向药物
Pancreatic neuroendocrine tumor
Radionuclide therapy
Artificial intelligence
Grading
Targeted therapy
