炎症性肠病(IBD),包括溃疡性结肠炎(UC)和克罗恩病(CD),是慢性胃肠道炎症性疾病,其复杂的病因涉及遗传、环境和免疫因素。IBD患者常面临腹痛、腹泻等症状,严重影响生活质量。与此同时,抑郁症在全球范围内的发病率上升,对心理健康和身体健康产生广泛影响。研究显示,IBD患者中抑郁症的患病率高于普通人群,可能通过影响治疗依从性和免疫系统功能加剧IBD病程。本研究综述了抑郁状态对IBD影响的流行病学、病理生理机制及临床管理策略,探讨了两者间的相互作用及其对患者生活质量、治疗反应和预后的影响,并提出了综合性治疗方案。本文旨在为未来的研究方向和临床实践提供理论和实践基础。Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), is a chronic inflammatory disease of the gastrointestinal tract with a complex etiology involving genetic, environmental, and immunologic factors. Patients with IBD often face abdominal pain and diarrhea, which can have a serious impact on quality of life. At the same time, the prevalence of depression has increased globally, with wide-ranging effects on mental health and physical health. Studies have shown that the prevalence of depression is higher in IBD patients than in the general population, and may exacerbate the course of IBD by affecting treatment adherence and immune system function. This study reviewed the epidemiology, pathophysiologic mechanisms, and clinical management strategies of the effects of depressive states on IBD, explored the interactions between the two and their impact on patients’ quality of life, response to treatment, and prognosis, and proposed a comprehensive treatment program. This paper aims to provide a theoretical and practical basis for future research directions and clinical practice.
神经内分泌肿瘤(Neuroendocrine neoplasms, NENs)是一种异质性神经内分泌系统肿瘤,其特点是惰性的生长速率和分泌多种肽激素和生物胺的能力。主要发生在消化道系统,且胃肠胰部位更加多见。目前,胃肠胰NENs (Gastroenteropancreatic-NENs, GEP-NENs)已成为消化系统第二类常见的癌症肿瘤。临床常用的CgA、Syn、CD56、NSE及Ki-67和新兴潜在SSTR2、INSM1和CD200的生物标记物的表达在诊断GEP-NENs方面被不断研究,但在疾病的预测、预后等方面仍有缺陷,随着神经内分泌肿瘤类型不断细化,迫切需要更加准确的生物标记物。因此,深入了解上述标记物与疾病的关系不仅对GEP-NENs的预测、诊断、治疗和预后有着深刻意义,而且为这些难治性肿瘤提供潜在治疗靶点。Neuroendocrine neoplasms (NENs) are heterogeneous tumors of the neuroendocrine system characterized by inert growth rates and the ability to secrete multiple peptide hormones and biogenic amines. They occur mainly in the digestive system and are more common in gastroenteropancreatic sites. Currently, gastroenteropancreatic-NENs (GEP-NENs) have become the second most common type of cancerous tumors of the digestive system. The expression of clinically used biomarkers of CgA, Syn, CD56, NSE and Ki-67 and emerging potential SSTR2, INSM1 and CD200 have been continuously investigated in the diagnosis of GEP-NENs. However, they are still defective in the prediction of the disease, prognosis, etc. With the continuous refinement of neuroendocrine tumor types, there is an urgent need to continue with more accurate biomarkers. Therefore, an in-depth understanding of the relationship between the above markers and the disease is not only of profound significance for the prediction, diagnosis, treatment and prognosis of GEP-NENs, but also provides potential therapeutic targets for these refractory tumors.
