Published online Dec 21, 2015. doi: 10.3748/wjg.v21.i47.13309
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
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.