The American Joint Committee on Cancer (AJCC) staging system for all cancer sites, including gastroenteropancreatic neuroendocrine tumors (GEP-NETs), is meant to be dynamic, requiring periodic updates to optimize AJCC staging definitions. This entails the collaboration of experts charged with evaluating new evidence that supports changes to each staging system. GEP-NETs are the second most prevalent neoplasm of gastrointestinal origin after colorectal cancer. Since publication of the AJCC eighth edition, the World Health Organization has updated the classification and separates grade 3 GEP-NETs from poorly differentiated neuroendocrine carcinoma. In addition, because of major advancements in diagnostic and therapeutic technologies for GEP-NETs, AJCC version 9 advocates against the use of serum chromogranin A for the diagnosis and monitoring of GEP-NETs. Furthermore, AJCC version 9 recognizes the increasing role of endoscopy and endoscopic resection in the diagnosis and management of NETs, particularly in the stomach, duodenum, and colorectum. Finally, T1NXM0 has been added to stage I in these disease sites as well as in the appendix.

中文翻译：

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神经内分泌肿瘤的关键更新：美国癌症联合委员会胃肠胰神经内分泌肿瘤分期系统第 9 版


美国癌症联合委员会 （AJCC） 针对所有癌症部位（包括胃肠胰神经内分泌肿瘤 （GEP-NETs））的分期系统是动态的，需要定期更新以优化 AJCC 分期定义。这需要负责评估支持每个分期系统变化的新证据的专家合作。GEP-NETs 是仅次于结直肠癌的第二大最常见的胃肠道起源性肿瘤。自 AJCC 第八版发布以来，世界卫生组织更新了分类并将 3 级 GEP-NET 与低分化神经内分泌癌分开。此外，由于 GEP-NETs 诊断和治疗技术的重大进步，AJCC 第 9 版主张反对使用血清嗜铬粒蛋白 A 来诊断和监测 GEP-NETs。此外，AJCC 第 9 版认识到内窥镜检查和内窥镜切除术在 NETs 的诊断和管理中的作用越来越大，尤其是在胃、十二指肠和结直肠中。最后，T1NXM0 已添加到这些疾病部位的 I 期以及附录中。