PMID- 30202829
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200930
IS  - 2472-1972 (Electronic)
IS  - 2472-1972 (Linking)
VI  - 2
IP  - 9
DP  - 2018 Sep 1
TI  - Diagnosing Nonfunctional Pancreatic NETs in MEN1: The Evidence Base.
PG  - 1067-1088
LID - 10.1210/js.2018-00087 [doi]
AB  - In multiple endocrine neoplasia type 1 (MEN1), nonfunctional pancreatic 
      neuroendocrine tumors (NF-pNETs) are the most frequently diagnosed NETs and a 
      leading cause of MEN1-related death. The high prevalence and malignant potential 
      of NF-pNETs outline the need for an evidence-based screening program, as early 
      diagnosis and timely intervention could reduce morbidity and mortality. 
      Controversies exist regarding the value of several diagnostic tests. This 
      systematic review aims to evaluate current literature and amplify an up-to-date 
      evidence-based approach to NF-pNET diagnosis in MEN1. Three databases were 
      systematically searched on the diagnostic value of biomarkers and imaging 
      modalities. Twenty-seven studies were included and critically appraised (modified 
      Quality Assessment of Diagnostic Accuracy Studies). Another 12 studies, providing 
      data on age-related penetrance and tumor growth, were included to assess the 
      optimal frequency and timing of screening. Based on current literature, 
      biomarkers should no longer play a role in the diagnostic process for NF-pNETs, 
      as accuracies are too low. Studies evaluating the diagnostic value of imaging 
      modalities are heterogeneous with varying risks of bias. For the detection of 
      NF-pNETs, endoscopic ultrasound (EUS) has the highest sensitivity. A combined 
      strategy of EUS and MRI seems to be the most useful. Gallium 68 octreotate-DOTA 
      positron emission tomography-CT could be added if NF-pNETs are diagnosed to 
      identify metastasis. Reported growth rates were generally low, and two distinct 
      phenotypes were observed. Surveillance programs should focus on and be adapted to 
      the presence of substantial growth in NF-pNETs. The optimal age to start 
      screening must yet be determined, as insufficient evidence for an evidence-based 
      recommendation was available.
FAU - van Treijen, Mark J C
AU  - van Treijen MJC
AD  - Department of Endocrine Oncology, University Medical Center Utrecht, Utrecht, 
      Netherlands.
FAU - van Beek, Dirk-Jan
AU  - van Beek DJ
AD  - Department of Endocrine Surgical Oncology, University Medical Center Utrecht, 
      Utrecht, Netherlands.
FAU - van Leeuwaarde, Rachel S
AU  - van Leeuwaarde RS
AD  - Department of Endocrine Oncology, University Medical Center Utrecht, Utrecht, 
      Netherlands.
FAU - Vriens, Menno R
AU  - Vriens MR
AD  - Department of Endocrine Surgical Oncology, University Medical Center Utrecht, 
      Utrecht, Netherlands.
FAU - Valk, Gerlof D
AU  - Valk GD
AD  - Department of Endocrine Oncology, University Medical Center Utrecht, Utrecht, 
      Netherlands.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20180731
PL  - United States
TA  - J Endocr Soc
JT  - Journal of the Endocrine Society
JID - 101697997
PMC - PMC6125714
OTO - NOTNLM
OT  - imaging modalities
OT  - multiple endocrine neoplasia type 1
OT  - pancreatic neuroendocrine tumors
OT  - screening
OT  - tumor markers
EDAT- 2018/09/12 06:00
MHDA- 2018/09/12 06:01
PMCR- 2018/07/31
CRDT- 2018/09/12 06:00
PHST- 2018/04/03 00:00 [received]
PHST- 2018/07/26 00:00 [accepted]
PHST- 2018/09/12 06:00 [entrez]
PHST- 2018/09/12 06:00 [pubmed]
PHST- 2018/09/12 06:01 [medline]
PHST- 2018/07/31 00:00 [pmc-release]
AID - js_201800087 [pii]
AID - 10.1210/js.2018-00087 [doi]
PST - epublish
SO  - J Endocr Soc. 2018 Jul 31;2(9):1067-1088. doi: 10.1210/js.2018-00087. eCollection 
      2018 Sep 1.