Tsai HM, Chuang CH, Shan YS, Liu YS, Chen CY. Features associated with progression of small pancreatic cystic lesions: A retrospective study. World J Gastroenterol 2015; 21(47): 13309-13315 [PMID: 26715814 DOI: 10.3748/wjg.v21.i47.13309]
Corresponding Author of This Article
Chiung-Yu Chen, MD, Associate Professor, Department of Internal Medicine, National Cheng Kung University Hospital, No. 138 Sheng-Li Road, Tainan 704, Taiwan. chiungyu@mail.ncku.edu.tw
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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/
Hong-Ming Tsai, Yi-Sheng Liu, Department of Radiology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
Chiao-Hsiung Chuang, Chiung-Yu Chen, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
Yan-Shen Shan, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
Author contributions: Chen CY was in charge of drafting and manuscript composition; Tsai HM and Liu YS contributed to the imaging review; Shan YS provided the original concept and study design; Chuang CH provided his expertise for data interpretation.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the National Cheng Kung University Hospital.
Informed consent statement: The IRB allowed us to waive the requirement for obtaining informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to have imaging study by written consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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/
Correspondence to: Chiung-Yu Chen, MD, Associate Professor, Department of Internal Medicine, National Cheng Kung University Hospital, No. 138 Sheng-Li Road, Tainan 704, Taiwan. chiungyu@mail.ncku.edu.tw
Received: May 13, 2015 Peer-review started: May 15, 2015 First decision: July 10, 2015 Revised: July 21, 2015 Accepted: October 12, 2015 Article in press: October 13, 2015 Published online: December 21, 2015 Processing time: 215 Days and 13.7 Hours
Abstract
AIM: To investigate the progression rate of small pancreatic cystic lesions and identify characteristics associated with their progression.
METHODS: Patients with pancreatic cystic lesions with at least 1-year of follow-up were evaluated retrospectively. We excluded patients with cysts larger than 3 cm or with features that were a concern for malignancy. In total, 135 patients were evaluated. The interval progression of the cysts was examined. Characteristics were compared between patients with and without progression.
RESULTS: The pancreatic cysts ranged from 3 to 29 mm. The mean follow-up period was 4.5 ± 2.3 years and the mean progression rate was 1.0 ± 1.3 mm/year. Ninety patients showed interval progression and were divided into two groups; the minimal-change group (n = 41), who had cyst progression at less than 1 mm/year, and the progression group (n = 49), who had a progression rate of more than 1 mm/year. Compared with the cysts without progression, the lesions of the progression group were more frequently associated with tubular cyst, septation or a prominent pancreatic duct (P < 0.05). The odds ratio for progression was 5.318 for septation and 4.582 for tubular cysts.
CONCLUSION: Small pancreatic cysts progress slowly. Lesions with tubular shape, septa, or prominent pancreatic duct were more likely to progress, and required further diagnostic intervention or shorter surveillance interval.
Core tip: Observation is advised for small pancreatic cyst without features that are a concern for malignancy. Our study determined that small pancreatic cysts with borderline pancreatic duct dilation, tubular shape, or septa were associated with risk of progression. Our findings may be helpful to stratify patients for different management planning according to their risk of progression.
