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Stratification Based on Risk Factors at Diagnosis Could Predict Progression in Patients with Pancreatic Cysts
Ryo Sugio1, Tsutomu Nishida2, Kengo Matsumoto1
1Department of Gastroenterology, Toyonaka Municipal Hospital, 4-14-1 Shibahara, Toyonaka, Osaka, 560-8565, Japan.
Background:
Predicting the risk of malignant transformation in pancreatic cyst patients is challenging.
Aim:
We retrospectively investigated the risk factors for malignant transformation in pancreatic cyst patients.
Methods:
Patients with pancreatic cysts diagnosed using imaging tests were followed from November 2008 to December 2021. A significant change was defined as the additional development of high-risk stigmata (HRS), worrisome features (WFs), or pancreatic cancer during monitoring.
Results:
In total, 479 patients were analyzed, with a median observation period of 50 months. Forty-four patients (9.2%) showed significant changes, and eight (1.7%) developed pancreatic cancer. The univariate analysis showed that the cyst diameter at diagnosis (≥ 14 mm), main pancreatic duct (MPD) diameter at diagnosis (≥ 3 mm), presence of multilocular cysts, and an inconsistent MPD caliber were significant predictive factors for a significant change. One point was assigned for each significant factor. We grouped the patients into three groups: the low-risk group (total score 0), medium-risk group (score 1-2), and high-risk group (score 3-4). The high-risk group had a higher risk of a significant change than the medium- and low-risk groups (age-adjusted HRs for the medium-risk and high-risk groups were 3.0 and 5.2 compared with the low-risk group).
Conclusion:
Stratification based on risk factors may help predict the development of significant changes in pancreatic cyst patients.
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