Natural history of pancreatic cystic lesions: a multicenter prospective observational study for evaluating the risk of pancreatic cancer

摘要: Backgroud and Aim To elucidate the natural history of pancreatic cystic lesions (PCLs), including branch-duct intraductal papillary mucinous neoplasm (BD-IPMN), via mid-term follow-up analysis a multicenter prospective observational study (NSPINAL study). Methods From July 2011 to October 2016, 881 patients with PCLs were enrolled in NSPINAL study, 664 >12 months analysed. Every patient was asymptomatic, endoscopic ultrasound (EUS) performed at initial diagnosis exclude high-risk individuals. Follow-up included EUS, CT or MRI least once year. Serial morphological changes cancer (PC) incidence, malignant progression PCLs, evaluated. Results The (358 men) followed for median 33.5 (IQR 29). The cyst MPD sizes 16.6±9.3 mm 2.3±1.0 mm, respectively. Morphologically, 518 cases multilocular, 137 unilocular, 9 had honeycomb pattern; 269 involved multifocal lesions. Ninety-six (14.5%) showed worsening on imaging. There 2 resectable 4 unresectable ductal adenocarcinoma (PDAC) 3 BD-IPMN. 3-year risk developing PC 1.2%. standardized incidence ratio (SIR) among 10.0 (95% CI 3.5–16.5), SIR BD-IPMN 16.6 5.1–28.1). Multivariate that development symptoms significant predictors PC. Conclusions Malignant development, is not uncommon. Patients should be carefully monitored detect PDAC early stages.