中国实用外科杂志

中国实用外科杂志

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美国癌症联合委员会第9版胃肠胰神经内分泌肿瘤分期系统解读

吴嘉文，李启元，孙    备   

  1. 哈尔滨医科大学附属第一医院胰胆外科 肝脾外科教育部重点实验室，黑龙江哈尔滨150001
  • 出版日期:2025-01-01

  • Online:2025-01-01

摘要： 胃肠胰神经内分泌肿瘤异质性较强，预后影响因素复杂，如何规范诊疗以进一步提高病人长期生存质量是临床所面临的难题。美国癌症联合委员会（AJCC）于2024年1月颁布了第9版胃肠胰神经内分泌肿瘤分期系统。相较于第8版，第9版分期系统做出如下更新：对胃、十二指肠/壶腹、阑尾及结肠/直肠的Nx肿瘤进一步分期；强调内镜诊断及治疗的重要作用；重视质子泵抑制剂（PPI）相关胃神经内分泌肿瘤的诊治；以及某些诊断标记物及预后影响因子的更新，整体分期趋于精准化、综合化。AJCC肿瘤分期系统在全球范围内具有权威的影响力，期待未来更多循证医学证据的问世，从而使胃肠胰神经内分泌肿瘤的治疗更加规范。

关键词: 胃肠胰神经内分泌肿瘤, AJCC分期, 肿瘤异质性, 内镜治疗, 肿瘤标记物

Abstract: Gastroenteropancreatic neuroendocrine tumors（GEP-NETs）exhibit significant heterogeneity and complex prognostic factors，presenting a longstanding challenge in standardizing treatment to improve long-term patient survival.The American Joint Committee on Cancer（AJCC）implemented the 9th edition of the staging system for GEP-NETs in January 2024.Compared to the previous edition，the new system includes several updates：further staging for Nx tumors of the stomach，duodenum/ampulla，appendix，and colon/rectum；emphasize of the importance of endoscopic diagnosis and treatment；emphasis on the diagnosis and treatment of PPI-related gastric neuroendocrine tumors；and updates on certain diagnostic markers and prognostic factors.Overall，the staging system is becoming more precise and comprehensive.The AJCC staging system holds authoritative influence worldwide，and it is anticipated that future evidence-based medical research will further standardize the treatments of GEP-NETs.

Key words: gastroenteropancreatic neuroendocrine tumors, AJCC staging, tumor heterogeneity, endoscopic treatment, tumor markers