Branch-duct intraductal papillary mucinous neoplasm:a retrospective study on neoplastic risk after 5 years of surveillance  

作　　者：Marie-Pier Bachand Mohamed-Anas Chennouf Mandy Malick Annie Beaudoin 

机构地区：[1]Division of Gastroenterology,Centre Hospitalier Universitaire Sherbrooke,Sherbrooke,QC,Canada [2]Division of Medicine,University of Sherbrooke,Sherbrooke,QC,Canada

出　　处：《Journal of Pancreatology》2024年第4期279-284,共6页胰腺病学杂志(英文)

摘　　要：Objectives:Long-term surveillance of branch-duct intraductal papillary mucinous neoplasms(BD-IPMN)remains controversial,particularly regarding cysts follow-up>5 years.The primary endpoint of this study was to assess the risk of malignant transforma-tion of presumed BD-IPMN during follow-up and identify clinical and morphological predictors of malignancy.Methods:We performed a retrospective analysis of data from all patients with a presumed BD-IPMN diagnosis at the CIUSSS de l’Estrie CHUS,from 2004 to 2018.Results:The final database included 380 patients with presumed BD-IPMN with a median follow-up of 43.9 months(inter-quartile range[IQR]28.6-73.3 months).Mean age at diagnosis was 65.5 years[27-90],159 patients(42.8%)were male and 17 patients(4.5%)underwent resection of their lesion during their surveillance period.In our cohort,132 patients(34.7%)had a follow-up of>5 years.Overall risk of malignancy was 2.1%[0.9%-4.1%].During follow-up,neoplastic transformation was ob-served in 2 of 132 patients(1.5%)surveilled>5 years.Malignancy was significantly associated with cyst growth>2.5 mm/y(57.1%vs 5.8%;P<.001)dilated MPD(71.4%vs 4.9%;P<.001),solid component(71.4%vs 1.3%;P<.001),positive cytology(37.5%vs 0.5%;P<.001),development of high-risk stigmatas(87.5%vs 1.9%;P<.001),or worrisome features(87.5%vs 23.9%;P<.001)during follow-up and symptoms of jaundice(25%vs 0.5%;P=.002)and abdominal pain(50%vs 9.4%;P=.005).Conclusion:While overall malignancy risk remains low in presumed BD-IPMN,continuous surveillance should be pursued after 5 years in surgically fit individuals,particularly in patients who develop our identified risk factors.

关 键 词：Intraductal papillary mucinous neoplasm Pancreatic cancer Pancreatic cyst PROGRESSION SURVEILLANCE 

分 类 号：R73[医药卫生—肿瘤]