[Interpretation of updated international guidelines for diagnosis and treatment of gastroenter-opancreatic neuroendocrine neoplasms].

The incidence of neuroendocrine neoplasms (NEN) is continuously increasing with gastrointestinal tract and pancreas being the most common primary sites. Currently, the guidelines proposed by European Neuroendocrine Tumor Society (ENETS), National Comprehensive Cancer Network (NCCN), European Society for Medical Oncology (ESMO) and North American Neuroendocrine Tumor Society (NANETS) are being widely applied. Among these, ENETS and NANETS guidelines were proposed in 2017 while ESMO and NCCN recently updated their guidelines for gastroenteropancreatic NEN in 2020 and 2021, respectively. This article interprets the diagnosis and treatment of gastroenteropancreatic NEN based on the newly updated ESMO and NCCN guidelines. The diagnosis of gastroenteropancreatic NEN depends on histological assessment including morphological evaluation, grading and immunohistochemistry results. Combination of different imaging methods can help determine tumor staging and risk assessment. Decision-making of treatment and follow-up strategies is based on primary tumor site, tumor classification, tumor grade, tumor type, functional status etc.神经内分泌肿瘤（NEN）的发病率在不断上升，胃肠道和胰腺是最常见的发病部位。目前，使用较广的胃肠胰NEN国际指南主要包括欧洲神经内分泌肿瘤学会（ENETS）指南、美国国立综合癌症网络（NCCN）指南、欧洲肿瘤内科学会（ESMO）指南和北美神经内分泌肿瘤学会（NANETS）指南。其中，ENETS和NANETS关于胃肠胰NEN的最新指南均发布于2017年，而ESMO指南和NCCN指南分别于2020年及2021年发布了更新版本，因此，本文主要根据ESMO指南和NCCN指南，并参照ENETS指南进行解读。胃肠胰NEN的诊断依赖于病理形态学、分级及免疫组织化学染色，合理运用影像学检查可明确肿瘤分期并进行风险评估。治疗和随访方案的制定需根据肿瘤原发部位、肿瘤分期、肿瘤分类及分级、肿瘤分型和功能状态等因素来确定。.