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Updated: Mar 31, 2026
Author Spotlight: Advancing Early Detection and Treatment of Gastrointestinal Tumors
Published on: February 16, 2024
Risk prediction model for high-grade dysplasia in resected pancreatic mucinous cystic neoplasms: a nomogram-based
Lina Aguilera Munoz1, Lucie Laurent2, Sandra Salmeron2
1Department of Pancreatology and Digestive Oncology, Université Paris Cité, Beaujon University Hospital, APHP.Nord, CRMR PaRaDis Pancreatic Rare Diseases, Clichy, France; Centre of Research on Inflammation (CRI), INSERM U1149, Paris, France.
Background:
Mucinous cystic neoplasms (MCN) are precancerous pancreatic lesions. Their management is challenged by the lack of robust predictors of malignancy. This study aimed to identify preoperative predictors of high-grade dysplasia (HGD) or invasive carcinoma and to develop a predictive nomogram.
Methods:
This multicenter retrospective study included patients who underwent resection for MCN between 2008 and 2021 across 13 centers. Surgical decisions were based on European guideline criteria. Diagnosis required ovarian-type stroma. Preoperative CT/MRI were centrally reviewed by an expert radiologist blinded to pathology. Independent predictors of ≥HGD were identified using multivariable logistic regression.
Results:
Among 198 patients, 32 (16 %) had ≥ HGD, including 14 (7 %) with invasive carcinoma. Independent predictors were older age (median 52.5 vs 45 years, p = 0.01), symptomatic presentation (72% vs 47%, OR 2.88, p = 0.01), larger cyst size (85 vs 46.5 mm, p < 0.001), and mural nodules (56% vs 15 %, OR 7.25, p < 0.001). The nomogram achieved an accuracy of 0.89 and an AUC of 0.86; a 10% risk threshold provided 85 % sensitivity. An interactive web-based calculator is publicly available.
Conclusion:
Age, symptoms, cyst size, and mural nodules independently predict malignancy in resected MCNs. A validated nomogram and online calculator may support individualized surgical versus surveillance strategies.
