Tumores neuroendócrinos do trato gastrointestinal

Alves, Jarcedy M.; Souza, Hamilton Petry de; Toneto, Marcelo C.; Reinehr, Denis; Reichel, Carlos Luiz; Gabiatti, Gémerson

doi:10.1590/S0100-69911999000500010

Resumos

Os tumores neuroendócrinos (TNE) já foram considerados raridades. Atualmente, através de novas técnicas para seu reconhecimento, tem-se identificado um número crescente destas neoplasias, sendo possível estratificá-las em subgrupos, expandindo o espectro dos neoplasmas neuroendócrinos e sua importância na prática cirúrgica atual. A imunocitoquímica, a dosagem de peptídeos e os modernos métodos de imagem proporcionam informações imprescindíveis para um diagnóstico acurado e o tratamento adequado. Este artigo tem por objetivo revisar aspectos referentes aos tumores neuroendócrinos do trato gastrointestinal relativos à história, fisiopatologia, classificação atualizada, diagnóstico e tratamento.

Tumores neuroendócrinos; Trato gastrointestinal; Imunocitoquírnica; Cintilografia

Neuroendocrine tumors were previously considered rarieties. However with the new techniques for its recognition, they have been in a identified growing number of cases, making it possible to stratify them in subgroups. The imunocitochemistry peptide dosage and modern imaging techniques provide essential informations from acurate diagnosis and appropriate treatment. The objective of this review is to discuss the aspects of neuroendocrine tumors of the gastrointestinal tract.

Neuroendocrine tumors; Gastrointestinal tract; lmunocitochemistry; Cintilography

ARTIGO DE ATUALIZAÇÃO

Tumores neuroendócrinos do trato gastrointestinal

Neuroendocrine tumors of the gastrointestinal tract

Jarcedy M. Alves^I; Hamilton Petry de Souza, TCBC-RS^II; Marcelo C. Toneto^III; Denis Reinehr^IV; Carlos Luiz Reichel^V; Gémerson Gabiatti^VI

^IProfessor Adjunto da Disciplina de Cirurgia Abdominal da FAMED-PUCRS

^IIProfessor Adjunto da Disciplina de Cirurgia Abdominal da FAMED-PUCRS. Coordenador do Departamento de Cirurgia da FAMED-PUCRS. Chefe do Serviço de Cirurgia Abdominal do HSL-PUCRS. FACS (Fellow American College of Surgeons)

^IIIMembro do Serviço de Cirurgia Abdominal do HSL-PUCRS

^IVCirurgião Geral. Pós-Graduando em Endoscopia Digestiva pela Fundação de Gastroenterologia (FUGAST)

^VProfessor Titular do Departamento de Patologia e Radiações da FAMED-PUCRS. Chefe do Serviço de Anatomia Patológica e Citologia do HSL-PUCRS

^VICirurgião Geral. Residente em Cirurgia do Trauma do Hospital de Pronto Socorro de Porto Alegre

^{Endereço para correspondência} Endereço para correspondência: Dr Hamilton Petry de Souza Rua Antonio Parreiras, 145 Apto 401 90450-050 - Porto Alegre RS E-mail: hpetry@conex.com.br

RESUMO

OS tumores neuroendócrinos (TNE) já foram considerados raridades. Atualmente, através de novas técnicas para seu reconhecimento, tem-se identificado um número crescente destas neoplasias, sendo possível estratificá-las em subgrupos, expandindo o espectro dos neoplasmas neuroendócrinos e sua importância na prática cirúrgica atual. A imunocitoquímica, a dosagem de peptídeos e os modernos métodos de imagem proporcionam informações imprescindíveis para um diagnóstico acurado e o tratamento adequado. Este artigo tem por objetivo revisar aspectos referentes aos tumores neuroendócrinos do trato gastrointestinal relativos à história, fisiopatologia, classificação atualizada, diagnóstico e tratamento.

Unitermos: Tumores neuroendócrinos; Trato gastrointestinal; Imunocitoquírnica; Cintilografia.

ABSTRACT

Neuroendocrine tumors were previously considered rarieties. However with the new techniques for its recognition, they have been in a identified growing number of cases, making it possible to stratify them in subgroups. The imunocitochemistry peptide dosage and modern imaging techniques provide essential informations from acurate diagnosis and appropriate treatment. The objective of this review is to discuss the aspects of neuroendocrine tumors of the gastrointestinal tract.

Key words: Neuroendocrine tumors; Gastrointestinal tract; lmunocitochemistry; Cintilography.

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Full text available only in PDF format.

REFERÊNCIAS

1. Ahlman H, Nilsson O, Wangberg B, Oahlstrom A. Neuroendocrine insights from the laboratory to the clinic. Am J Surg 1996;172: 61-7.

2. Akerstrom G. Management of carcinoid tumors of the stomach, duodenum, and pancreas. World Surg 1996;20:173-82

3. Bax NOS, Woods HF, Batchelor A, Jennings M. Clinical manifestations of carcinoid disease. World J Surg 1996;20:142-6.

4. Bordi C. Endocrine tumors of the stomach. Path Res Pract 1995; 191: 373-80.

5. Creutzfeldt W. Carcinoid tumors: development of our knowledge. World J Surg 1996;20:126-31.

6. Gilligan CJ, Lawton GP, Tang LH, et al. Gastric carcinoid tumors: The biology and therapy of an enigmatic and controversial lesion. Am J Gastroenterol 1995; 90:338-52.

7. Janson ET, Holmberg L, Stridsberg M, et al. Carcinoid tumors: analysis of prognostic factors and survival in 30 I patients from a referral center. Ann Oncol 1997;8:685-90.

8. Kloppel G, Heitz PU, Capella C, Solcia E. Pathology and nomenclature of human gastrointestinal neuroendocrine tumors and related lesions. World J Surg 1996;20:132-141.

9. Memon MA. Gastrointestinal carcinoid tumors: current management strategies. Dis Colon Rectum 1997;40:1101-17.

10. Modlin IM, Gilligan CJ, Lawton GP, et al. Gastric carcinoids: The Yale Experience. Arch Surg 1995;130: 250-6.

11. Modlin IM, Tang LH. Approaches to the diagnosis of gut neuroendocrine tumors: the last word (today). Gastroenterology 1997; 112:583-90.

12. Oberg K. Neuroendocrine gastrointestinal tumors. Ann Oncol 1996; 7:453-63.

13. Rindi G. Gastric carcinoids and neuroendocrine carcinomas: pathogenesis, pathology and behaviour. World J Surg 1996;20: 168-72.

14. Wang OG. Oncogene expression in gastroenteropancreatic neuroendocrine tumors. Cancer 1997;80:668-75.

15. Critcley M. Octreotide scanning for carcinoid tumours. Postgrad Med J 1997;73:399-402.

16. Craig SR. Primary small-cell cancer of the esophagus. J Thorac Cardio- vasc SurgI995;109:284-8.

17. Macedo ILS. Small cell carcinoma of the esophagus. Rev Col Bras Cir 1997;24:270-2.

18. Eriksson B. Neuroendocrine pancreatic tumors: clinical presentation, biochemical and histopathological findings in 84 patients. J lnt Med 1990;228:103-13.

19. Eriksson B. Medical treatment and long-term survival in a prospective study of 84 patients with endocrine pancreatic tumors. Cancer 1990; 65:1.883-90.

20. Debas HT. Neuroendocrine gut neoplasms. Important lessons from uncommon tumors. Arch Surg 1994;129:965-72.

21. Waldum HL. Neuroendocrine diferentiation in human gastric carcinoma. Cancer 1998;83:435-44.

22; Souza HP. Carcinoma de pequenas células do esôfago. Rev Col Bras Cir 1998;25:290-92.

Recebido em 5/4/99

Aceito para publicação em 19/8/99

Trabalho realizado na Pontifícia Universidade Católica do Rio Grande do Sul, Departamento de Cirurgia do Hospital São Lucas e Faculdade de Medicina da PUCRS.

1. Ahlman H, Nilsson O, Wangberg B, Oahlstrom A. Neuroendocrine insights from the laboratory to the clinic. Am J Surg 1996;172: 61-7.
2. Akerstrom G. Management of carcinoid tumors of the stomach, duodenum, and pancreas. World Surg 1996;20:173-82
3. Bax NOS, Woods HF, Batchelor A, Jennings M. Clinical manifestations of carcinoid disease. World J Surg 1996;20:142-6.
4. Bordi C. Endocrine tumors of the stomach. Path Res Pract 1995; 191: 373-80.
5. Creutzfeldt W. Carcinoid tumors: development of our knowledge. World J Surg 1996;20:126-31.
6. Gilligan CJ, Lawton GP, Tang LH, et al. Gastric carcinoid tumors: The biology and therapy of an enigmatic and controversial lesion. Am J Gastroenterol 1995; 90:338-52.
7. Janson ET, Holmberg L, Stridsberg M, et al. Carcinoid tumors: analysis of prognostic factors and survival in 30 I patients from a referral center. Ann Oncol 1997;8:685-90.
8. Kloppel G, Heitz PU, Capella C, Solcia E. Pathology and nomenclature of human gastrointestinal neuroendocrine tumors and related lesions. World J Surg 1996;20:132-141.
9. Memon MA. Gastrointestinal carcinoid tumors: current management strategies. Dis Colon Rectum 1997;40:1101-17.
10. Modlin IM, Gilligan CJ, Lawton GP, et al. Gastric carcinoids: The Yale Experience. Arch Surg 1995;130: 250-6.
11. Modlin IM, Tang LH. Approaches to the diagnosis of gut neuroendocrine tumors: the last word (today). Gastroenterology 1997; 112:583-90.
12. Oberg K. Neuroendocrine gastrointestinal tumors. Ann Oncol 1996; 7:453-63.
13. Rindi G. Gastric carcinoids and neuroendocrine carcinomas: pathogenesis, pathology and behaviour. World J Surg 1996;20: 168-72.
14. Wang OG. Oncogene expression in gastroenteropancreatic neuroendocrine tumors. Cancer 1997;80:668-75.
15. Critcley M. Octreotide scanning for carcinoid tumours. Postgrad Med J 1997;73:399-402.
16. Craig SR. Primary small-cell cancer of the esophagus. J Thorac Cardio- vasc SurgI995;109:284-8.
17. Macedo ILS. Small cell carcinoma of the esophagus. Rev Col Bras Cir 1997;24:270-2.
18. Eriksson B. Neuroendocrine pancreatic tumors: clinical presentation, biochemical and histopathological findings in 84 patients. J lnt Med 1990;228:103-13.
19. Eriksson B. Medical treatment and long-term survival in a prospective study of 84 patients with endocrine pancreatic tumors. Cancer 1990; 65:1.883-90.
20. Debas HT. Neuroendocrine gut neoplasms. Important lessons from uncommon tumors. Arch Surg 1994;129:965-72.
21. Waldum HL. Neuroendocrine diferentiation in human gastric carcinoma. Cancer 1998;83:435-44.
22; Souza HP. Carcinoma de pequenas células do esôfago. Rev Col Bras Cir 1998;25:290-92.

Endereço para correspondência:

Dr Hamilton Petry de Souza

Rua Antonio Parreiras, 145 Apto 401

90450-050 - Porto Alegre RS

E-mail:

hpetry@conex.com.br

Datas de Publicação

Publicação nesta coleção
24 Nov 2009
Data do Fascículo
Out 1999

Histórico

Aceito
19 Ago 1999
Recebido
05 Abr 1999

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Ahlman H, Nilsson O, Wangberg B, Oahlstrom A. Neuroendocrine insights from the laboratory to the clinic. Am J Surg 1996;172: 61-7.

[2] 2. Akerstrom G. Management of carcinoid tumors of the stomach, duodenum, and pancreas. World Surg 1996;20:173-82

[3] 3. Bax NOS, Woods HF, Batchelor A, Jennings M. Clinical manifestations of carcinoid disease. World J Surg 1996;20:142-6.

[4] 4. Bordi C. Endocrine tumors of the stomach. Path Res Pract 1995; 191: 373-80.

[5] 5. Creutzfeldt W. Carcinoid tumors: development of our knowledge. World J Surg 1996;20:126-31.

[6] 6. Gilligan CJ, Lawton GP, Tang LH, et al. Gastric carcinoid tumors: The biology and therapy of an enigmatic and controversial lesion. Am J Gastroenterol 1995; 90:338-52.

[7] 7. Janson ET, Holmberg L, Stridsberg M, et al. Carcinoid tumors: analysis of prognostic factors and survival in 30 I patients from a referral center. Ann Oncol 1997;8:685-90.

[8] 8. Kloppel G, Heitz PU, Capella C, Solcia E. Pathology and nomenclature of human gastrointestinal neuroendocrine tumors and related lesions. World J Surg 1996;20:132-141.

[9] 9. Memon MA. Gastrointestinal carcinoid tumors: current management strategies. Dis Colon Rectum 1997;40:1101-17.

[10] 10. Modlin IM, Gilligan CJ, Lawton GP, et al. Gastric carcinoids: The Yale Experience. Arch Surg 1995;130: 250-6.

[11] 11. Modlin IM, Tang LH. Approaches to the diagnosis of gut neuroendocrine tumors: the last word (today). Gastroenterology 1997; 112:583-90.

[12] 12. Oberg K. Neuroendocrine gastrointestinal tumors. Ann Oncol 1996; 7:453-63.

[13] 13. Rindi G. Gastric carcinoids and neuroendocrine carcinomas: pathogenesis, pathology and behaviour. World J Surg 1996;20: 168-72.

[14] 14. Wang OG. Oncogene expression in gastroenteropancreatic neuroendocrine tumors. Cancer 1997;80:668-75.

[15] 15. Critcley M. Octreotide scanning for carcinoid tumours. Postgrad Med J 1997;73:399-402.

[16] 16. Craig SR. Primary small-cell cancer of the esophagus. J Thorac Cardio- vasc SurgI995;109:284-8.

[17] 17. Macedo ILS. Small cell carcinoma of the esophagus. Rev Col Bras Cir 1997;24:270-2.

[18] 18. Eriksson B. Neuroendocrine pancreatic tumors: clinical presentation, biochemical and histopathological findings in 84 patients. J lnt Med 1990;228:103-13.

[19] 19. Eriksson B. Medical treatment and long-term survival in a prospective study of 84 patients with endocrine pancreatic tumors. Cancer 1990; 65:1.883-90.

[20] 20. Debas HT. Neuroendocrine gut neoplasms. Important lessons from uncommon tumors. Arch Surg 1994;129:965-72.

[21] 21. Waldum HL. Neuroendocrine diferentiation in human gastric carcinoma. Cancer 1998;83:435-44.

[22] 22; Souza HP. Carcinoma de pequenas células do esôfago. Rev Col Bras Cir 1998;25:290-92.

Brasil

Brasil

Tumores neuroendócrinos do trato gastrointestinal

Neuroendocrine tumors of the gastrointestinal tract

Resumos

Endereço para correspondência:

Datas de Publicação

Histórico