Pancreatic neuroendocrine neoplasms are a rare and complex group of neoplastic lesions that develop from pancreatic islet cells.Their incidence has dramatically increased during the last two decades.Due to its complex...Pancreatic neuroendocrine neoplasms are a rare and complex group of neoplastic lesions that develop from pancreatic islet cells.Their incidence has dramatically increased during the last two decades.Due to its complex nature and pathophysiological behaviour,surgical management continues to evolve.Surgery remains the cornerstone of treatment for most non-functional and functional pancreatic neuroendocrine tumours,while lymphadenectomy remains a controversial subject.Different techniques,such as pancreas-preserving and minimally invasive approaches,continue to evolve and offer the same overall outcomes as open surgery.This comprehensive review describes in detail the current and most up-todate classification and staging of pancreatic neuroendocrine tumours,explores the rationale for nonsurgical and surgical management,and focuses on surgical treatment and more specifically,on minimally invasive approaches.展开更多
Pituitary neuroendocrine tumors(PitNETs)are pathologically characterized by dysregulation of neuroendocrine function and systemic disruption of hormonal homeostasis,yet their regulatory effects on peripheral immune ne...Pituitary neuroendocrine tumors(PitNETs)are pathologically characterized by dysregulation of neuroendocrine function and systemic disruption of hormonal homeostasis,yet their regulatory effects on peripheral immune networks remain poorly characterized.Here,we systematically analyzed bulk RNA sequencing(RNA‑seq)from 883 PitNET tumors,108 PitNET‑associated peripheral blood mononuclear cells(PBMC)samples,and 175 healthy PBMC controls,combined with 69 single‑cell RNA sequencing(scRNA-seq)samples covering tumors,normal pituitaries,as well as tumor‑derived and normal PBMCs.We identified a systemic immune disequilibrium in PitNET patients,characterized by increased circulating lymphocyte proportions,accompanied by upregulated cytokine-receptor interaction signatures.Notably,tumor resection reversed this imbalance,as supported by the normalization of monocyte and neutrophil counts,validated by flow cytometry and routine blood data from 600 samples(200 healthy controls and 200 PitNET patients with paired pre-and post-surgery follow‑up).Trajectory analysis identified terminally differentiated,secretory-specialized cell populations with lineage-specific hormone and cytokine hypersecretion.Ligand-receptor inference suggested these tumor-derived factors potentially engage circulating immune cell receptors.A random‑forest classifier based on PBMC transcriptomes distinguished PitNET subtypes,underscoring the diagnostic potential of peripheral immune signatures.Furthermore,in an estrogen-induced rat model,elevated PRL level coincided with the same peripheral immune skewing.Overall,our work provides a valuable resource and demonstrates PitNETs can be systemic immune modulators,where intrinsic hormone secretory activity and monocyte-lymphocyte imbalance collectively drive peripheral immune dysfunction.展开更多
文摘Pancreatic neuroendocrine neoplasms are a rare and complex group of neoplastic lesions that develop from pancreatic islet cells.Their incidence has dramatically increased during the last two decades.Due to its complex nature and pathophysiological behaviour,surgical management continues to evolve.Surgery remains the cornerstone of treatment for most non-functional and functional pancreatic neuroendocrine tumours,while lymphadenectomy remains a controversial subject.Different techniques,such as pancreas-preserving and minimally invasive approaches,continue to evolve and offer the same overall outcomes as open surgery.This comprehensive review describes in detail the current and most up-todate classification and staging of pancreatic neuroendocrine tumours,explores the rationale for nonsurgical and surgical management,and focuses on surgical treatment and more specifically,on minimally invasive approaches.
基金supported by the National Research Center for Translational Medicine under grant number NRCTM(SH)2023-15(to Z-B.W.)Fundamental Research Funds for the Central Universities(No.YG2023ZD06 to Z-B.W.)+3 种基金National Natural Science Foundation of China(82472640 to Z-B.W.,82373131 and 82573142 to S-J.L.,82200153 to Y-T.D.,82500265 to S-S.Y.)Health care leader of Shanghai Municipal Health Commission(No.2022LJ006 to Z-B.W.)the Natural Science Foundation of Shanghai,China(25ZR1402349 to S-S.Y.)the Innovative Research Team of HighLevel Local Universities in Shanghai.
文摘Pituitary neuroendocrine tumors(PitNETs)are pathologically characterized by dysregulation of neuroendocrine function and systemic disruption of hormonal homeostasis,yet their regulatory effects on peripheral immune networks remain poorly characterized.Here,we systematically analyzed bulk RNA sequencing(RNA‑seq)from 883 PitNET tumors,108 PitNET‑associated peripheral blood mononuclear cells(PBMC)samples,and 175 healthy PBMC controls,combined with 69 single‑cell RNA sequencing(scRNA-seq)samples covering tumors,normal pituitaries,as well as tumor‑derived and normal PBMCs.We identified a systemic immune disequilibrium in PitNET patients,characterized by increased circulating lymphocyte proportions,accompanied by upregulated cytokine-receptor interaction signatures.Notably,tumor resection reversed this imbalance,as supported by the normalization of monocyte and neutrophil counts,validated by flow cytometry and routine blood data from 600 samples(200 healthy controls and 200 PitNET patients with paired pre-and post-surgery follow‑up).Trajectory analysis identified terminally differentiated,secretory-specialized cell populations with lineage-specific hormone and cytokine hypersecretion.Ligand-receptor inference suggested these tumor-derived factors potentially engage circulating immune cell receptors.A random‑forest classifier based on PBMC transcriptomes distinguished PitNET subtypes,underscoring the diagnostic potential of peripheral immune signatures.Furthermore,in an estrogen-induced rat model,elevated PRL level coincided with the same peripheral immune skewing.Overall,our work provides a valuable resource and demonstrates PitNETs can be systemic immune modulators,where intrinsic hormone secretory activity and monocyte-lymphocyte imbalance collectively drive peripheral immune dysfunction.
