Factors Associated with Gastric and Duodenal Neuroendocrine Tumor Development

초록

Gastroenteropancreatic neuroendocrine tumors(GEPNETs) originate from enterochromaffin-like cells of the gut or islets of Langerhans of the pancreas. GEP-NETs are heterogeneous in nature based on their primary site [1]. The incidence and prevalence of GEP-NETs has gradually increased over the last three decades. According to recent Surveillance, Epidemiology, and End Result (SEER) data, the annual age-adjusted incidence rate in the United States has increased from 1.09 per 100,000 people (1973) to 6.98 per 100,000 people (2012) [2]. In addition, the prevalence of GEP-NETs has increased from 0.006% (1993) to 0.048% (2012) [3]. The small intestine is the most commonly affected sites, followed by the rectum, pancreas, stomach, and appendix. These recent increases in the number of GEP-NETs may be related to the increased use of endoscopic screening, developments in nuclear medicine, and improved recognition [4,5]. Although the proportion of upper gastrointestinal NET, including gastric and duodenal NETs (GNETs and DNETs, respectively), is relatively low in GEP-NETs, they can be detected in endoscopic screening, and endoscopic resection is a favorable treatment option for small and superficial GNETs and DNETs [6-9]. However, in contrast to many previous studies focusing on the treatment outcome and prognosis of GNETs and DNETs, epidemiologic and clinical factors associated with GNETs and DNETs have rarely been investigated, and there have been some discrepancies between studies [10-14]. Recent studies have shown differences in the natural history and clinical characteristics of GNETs and DNETs [15,16]. However, GNETs and DNETs commonly originate from foregut organs and may share common associated factors, in addition to their site-specific risk factors. In contrast, esophageal NETs are extremely rare compared to GNETs and DNETs, and show relatively aggressive behavior among upper gastrointestinal NETs [17,18]; thus, they will not be covered in this review. Here, we summarize the results of previous studies on factors associated with GNETs and DNETs and introduce a recent Korean multicenter study on the factors associated with development of GNETs and DNETs.

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