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Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 16, 2021; 9(29): 8627-8646
Published online Oct 16, 2021. doi: 10.12998/wjcc.v9.i29.8627
Time to give up traditional methods for the management of gastrointestinal neuroendocrine tumours
Ahmet Yozgat, Murat Kekilli, Mustafa Altay
Ahmet Yozgat, Department of Gastroenterology, Ufuk University, Ankara, 06510, Turkey
Murat Kekilli, Department of Gastroenterology, Gazi University, Ankara 06560, Turkey
Mustafa Altay, Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Keçiören Health Administration and Research Center, Ankara 06190, Turkey
Author contributions: Yozgat A, Kekilli M, and Altay M designed the research study; Yozgat A, Kekilli M and Altay M performed the research; Yozgat A, Kekilli M, and Altay M contributed new reagents and analytic tools; Yozgat A, Kekilli M, and Altay M analyzed the data and wrote the manuscript; All authors have read and approve the final manuscript.
Conflict-of-interest statement: The authors that there are no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mustafa Altay, MD, Chairman, Professor, Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Keçiören Health Administration and Research Center, Sanatoryum Avenue. Pınarbaşı Neighb. Ardahan Street. No. 25 Pınarbaşı/ Keçiören/Ankara 06000, Turkey. mustafa.altay@sbu.edu.tr
Received: February 20, 2021
Peer-review started: February 20, 2021
First decision: May 3, 2021
Revised: May 19, 2021
Accepted: August 24, 2021
Article in press: August 24, 2021
Published online: October 16, 2021
Abstract

Neuroendocrine tumors (NETs) are a rare and heterogeneous disease group and constitute 0.5% of all malignancies. The annual incidence of NETs is increasing worldwide. The reason for the increase in the incidence of NETs is the detection of benign lesions, incidental detection due to the highest use of endoscopic and imaging procedures, and higher recognition rates of pathologists. There have been exciting developments regarding NET biology in recent years. Among these, first of all, somatostatin receptors and downstream pathways in neuroendocrine cells have been found to be important regulatory mechanisms for protein synthesis, hormone secretion, and proliferation. Subsequently, activation of the mammalian target of rapamycin pathway was found to be an important mechanism in angiogenesis and tumor survival and cell metabolism. Finally, the importance of proangiogenic factors (platelet-derived growth factor, vascular endothelial growth factor, fibroblastic growth factor, angiopoietin, and semaphorins) in the progression of NET has been determined. Using the combination of biomarkers and imaging methods allows early evaluation of the appropriateness of treatment and response to treatment.

Keywords: Enterochromaffin cells, 68Ga-DOTATATE, Gastrointestinal, Neuroendocrine tumours, Somatostatin receptor, Targeted peptide receptor radiotherapy

Core Tip: Neuroendocrine tumors (NETs) originate from cells of the diffuse neuroendocrine system that can show both nerve and endocrine cell features and can be found in many organs in the body. NETs show different clinical and biological characteristics according to the regions where they develop. In recent years, there have been changes in the distribution of NETs within themselves, especially due to the more frequent use of screening colonoscopy and imaging methods. Using the combination of biomarkers and imaging methods allows early evaluation of the appropriateness of treatment and response to treatment.