Gastroenteropancreatic neuroendocrine tumors

Background. Neuroendocrine tumors represent a heterogeneous group of neoplasms that vary in localization, growth characteristics, and clinical symptoms, originating from neuroendocrine cells. More than half of neuroendocrine tumors arise from the endocrine system of the gastrointestinal tract and the pancreas. These tumors are relatively rare neoplasms; however, in recent years, the incidence of neuroendocrine tumors has increased. The widespread presence of cells from the diffuse neuroendocrine system in the body accounts for the variety of tumor locations. Gastrointestinal tract neuroendocrine tumors consist of different cell types: G, ECL, S, and others. The pathogenesis of the clinical manifestations of functionally active neuroendocrine tumors is determined by the action of the bioamines and hormonesthey secrete. The classification of neuroendocrine neoplasms into groups of highly and poorly differentiated neuroendocrine tumors is determined using the Ki-67 index. Based on their origin and clinical symptoms, carcinoid tumors are distinguished into asymptomatic tumors and those presenting with the clinical picture of carcinoid syndrome. The clinical picture of this syndrome is characterized by "flushing" caused by the production of histamine and bradykinin, which have a vasodilatory effect. According to their functional activity, gastroenteropancreatic tumors, which have the most clinical significance, are classified into carcinoid, insulinoma, somatostatinoma, glucagonoma, gastrinoma, VIPoma, and ACTH ectopic syndrome. Neuroendocrine tumors are included in hereditary syndromes and diseases, such as multiple endocrine neoplasia syndromes (MEN-1, MEN-2), von Hippe – Lindau disease, McCune – Albright syndrome, neurofibromatosis type 1, and Carney complex. Some neuroendocrine tumors have a long latent course, leading to diagnostic challenges.

Conclusion. Treatment of gastrointestinal tract and pancreatic neuroendocrine tumors requires a comprehensive approach aimed at regression of clinical symptoms, normalization of hormone production, removal of the tumor and its metastases, improving quality of life, and increasing survival rates.

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