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  

Interpretation of the American Joint Committee on Cancer(AJCC)9th Edition Staging System for patients with gastroenteropancreatic neuroendocrine tumors

作　　者：吴嘉文 李启元 孙备[1] WU Jia-wen;LI Qi-yuan;SUN Bei(Pancreatic and Biliary Surgery,the First Affiliated Hospital of Harbin Medical University&Key Laboratory of Hepatosplenic Surgery,Ministry of Education,Harbin 150001,China)

机构地区：[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　　处：《中国实用外科杂志》2025年第1期48-51,58,共5页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金项目(No.82270665,No.82470672);黑龙江省科学技术厅重点研发计划(创新基地)基金资助项目(No.JD2023SJ42)。

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。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.

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 

分 类 号：R6[医药卫生—外科学]