Rectal neuroendocrine tumors need to be treated like this

Neuroendocrine tumors are tumors that originate from neuroendocrine cells. In recent years, with the widespread use of instruments such as colonoscopes, more and more cases of rectal neuroendocrine tumors have been discovered. Many people are unfamiliar with rectal neuromas. Let us focus on understanding rectal endocrine tumors.

Rectal neuroendocrine tumors are tumors that arise from neuroendocrine cells. Neuroendocrine cells are a large class of cells in the body that have a neuroendocrine phenotype and can produce a variety of hormones. Neuroendocrine cells are found throughout the body, so rectal neuroendocrine tumors can occur anywhere in the body, but the most common are rectal neuroendocrine tumors in the digestive system, such as the stomach, intestines, and pancreas, which account for about 2/3 of all rectal neuroendocrine tumors. The incidence of rectal neuroendocrine tumors in European and American populations is between 2.5 and 5 per 100,000 people. The incidence has increased fivefold in the past 30 years. Compared with other tumors, the incidence of neuroendocrine tumors has increased more rapidly.

The diagnosis of rectal neuroendocrine tumors is based on corresponding clinical manifestations, tumor marker detection, imaging examinations and pathological examinations. A complete diagnosis includes tumor location, grade, stage, and functional status. Treatments for rectal neuroendocrine tumors include endoscopic surgery, surgical treatment, radiological intervention, radionuclide therapy, chemotherapy, biological therapy, molecular targeted therapy, etc. The choice of treatment depends on the grade, stage, location of the tumor, and whether it has the function of secreting hormones.

For localized tumors, radical surgical resection can be performed; for patients with advanced tumors, some can also receive palliative treatment through surgical tumor reduction surgery; for patients with only liver metastases, local treatment for liver metastatic lesions can be selected, including various ablations, hepatic artery embolization, radioactive particle implantation, and even liver transplantation; for metastatic rectal neuroendocrine tumors, radionuclide-labeled somatostatin analogs can also be used for peptide receptor-mediated radionuclide therapy.

Drug treatments for rectal neuroendocrine tumors include chemotherapy, biological therapy, and molecular targeted therapy. The goal of medical therapy is to control symptoms associated with functional rectal neuroendocrine tumors due to excess hormone secretion and to control tumor growth. The choice of drug also depends on the location, functional status, pathological grade and tumor stage of the tumor. Traditional cytotoxic chemotherapy drugs are effective for poorly differentiated G3 neuroendocrine carcinoma.

Although it is the first-line treatment, well-differentiated G1 and G2 rectal neuroendocrine tumors are not sensitive to chemotherapy. Biological therapy and targeted therapy are the main drug treatments for G1 and G2 rectal neuroendocrine tumors. Currently, the drugs used for biological treatment of rectal neuroendocrine tumors are mainly somatostatin analogs, including octreotide and lanreotide; targeted drugs include the mammalian target of rapamycin protein inhibitor everolimus and the receptor tyrosine kinase inhibitor sunitinib.