Supplementary Material for: Gastric NeuroendocrineTumours

Background: Gastric neuroendocrine tumours (NETs) are increasingly recognised, and management decisions may be difficult due to an incomplete understanding of aetiology, natural history and optimum therapy. This article presents a current understanding based on recent advances in epidemiology, classification, molecular profiling, and treatment. Methods: Relevant medical literature was identified from searches of PubMed and references cited in appropriate articles identified. Selection of articles was based on peer review, journal and relevance. Results: Gastric NETs may be divided into three clinical prognostic groups: type I is associated with autoimmune atrophic gastritis and hypergastrinaemia, type II is associated with Zollinger-Ellison syndrome, and type III lesions are gastrin-independent, have the greatest metastatic potential and poorest prognosis. There has been an increased frequency of gastric NETs reported. Management approaches have evolved in parallel with advances in endoscopic staging and surgery, as well as improved understanding of the biology and natural history of NETs. Conclusions: Gastric NETs present a spectrum of activity from indolent tumours to metastatic malignancy. Treatment decisions for patients must be individualised and are best managed by a multidisciplinary team approach. The current evidence base is limited to small series and efforts to treat patients within clinical networks of expertise are warranted.

背景：胃神经内分泌肿瘤（Gastric neuroendocrine tumours, NETs）的临床检出率日益提升，但由于对其病因、自然病程及最佳治疗方案的认知尚不充分，临床诊疗决策往往颇具挑战。本文基于流行病学、分类学、分子分型及治疗领域的最新研究进展，对当前该类肿瘤的认知现状进行综述。方法：通过检索PubMed数据库及已纳入文献的参考文献列表，筛选相关医学文献；文献遴选标准基于同行评议质量、期刊影响力及主题相关性。结果：胃神经内分泌肿瘤可分为三类临床预后分组：Ⅰ型与自身免疫性萎缩性胃炎及高胃泌素血症相关，Ⅱ型与佐林格-埃利森综合征（Zollinger-Ellison syndrome）相关，Ⅲ型病变为非胃泌素依赖性，其转移潜能最高且预后最差。临床报告的胃神经内分泌肿瘤病例数呈上升趋势。随着内镜分期、手术技术的进步，以及对神经内分泌肿瘤生物学特性与自然病程认知的加深，其诊疗策略也在不断更新完善。结论：胃神经内分泌肿瘤的疾病谱涵盖从惰性肿瘤到转移性恶性肿瘤的不同表型。患者的治疗方案需实现个体化定制，最佳诊疗模式为采用多学科团队协作。目前的循证医学证据多来源于小样本病例系列研究，因此有必要依托专业临床协作网络开展患者诊疗工作。