Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Jun 15, 2020; 12(6): 642-650
Published online Jun 15, 2020. doi: 10.4251/wjgo.v12.i6.642
Clinical diagnosis and management of pancreatic mucinous cystadenoma and cystadenocarcinoma: Single-center experience with 82 patients
Zhi-Ming Zhao, Nan Jiang, Yuan-Xing Gao, Zhu-Zeng Yin, Guo-Dong Zhao, Xiang-Long Tan, Yong Xu, Rong Liu
Zhi-Ming Zhao, Nan Jiang, Yuan-Xing Gao, Zhu-Zeng Yin, Guo-Dong Zhao, Xiang-Long Tan, Yong Xu, Rong Liu, Second Department of Hepatopancreatobiliary Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
Author contributions: Zhao ZM and Jiang N wrote the manuscript and contributed equally to this work and are co-first authors; Liu R conceived and designed the study; Jiang N, Gao YX, and Yin ZZ collected the data; Jiang N, Zhao GD, Tan XL, and Xu Y analyzed the data; all authors made critical revisions to the manuscript and approved the final version.
Institutional review board statement: The study was approved by the Institutional Review Board of the Chinese People's Liberation Army General Hospital (S2016-098-02).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors declare no conflicts-of-interest related to this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Rong Liu, MD, PhD, Professor, Second Department of Hepatopancreatobiliary Surgery, The First Medical Center of Chinese PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing 100853, China. liurong301@126.com
Received: April 30, 2020
Peer-review started: April 30, 2020
First decision: May 15, 2020
Revised: May 18, 2020
Accepted: May 21, 2020
Article in press: May 21, 2020
Published online: June 15, 2020
Processing time: 45 Days and 20.7 Hours
Abstract
BACKGROUND

Mucinous cystic neoplasm (MCN) of the pancreas is characterized by mucin-producing columnar epithelium and dense ovarian-type stroma and at risk for malignant transformation. Early diagnosis and treatment of MCN are particularly important.

AIM

To investigate the clinical characteristics of and management strategies for pancreatic mucinous cystadenoma (MCA) and mucinous cystadenocarcinoma (MCC).

METHODS

The clinical and pathological data of 82 patients with pancreatic MCA and MCC who underwent surgical resection at our department between April 2015 and March 2019 were retrospectively analyzed.

RESULTS

Of the 82 patients included in this study, 70 had MCA and 12 had MCC. Tumor size of MCC was larger than that of MCA (P = 0.049). Age and serum levels of tumor markers carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9, and CA12-5 were significantly higher in MCC than in MCA patients (P = 0.005, 0.026, and 0.037, respectively). MCA tumor size was positively correlated with serum CA19-9 levels (r = 0.389, P = 0.001). Compared with MCC, MCA had a higher minimally invasive surgery rate (P = 0.014). In the MCA group, the rate of major complications was 5.7% and that of clinically relevant pancreatic fistula was 8.6%; the corresponding rates in the MCC group were 16.7% and 16.7%, respectively.

CONCLUSION

Tumor size, age, and serum CEA, CA19-9, and CA12-5 levels may contribute to management of patients with MCN. Surgical resection is the primary treatment modality for MCC and MCA.

Keywords: Pancreatic neoplasms, Mucinous cystadenoma, Mucinous cystadenocarcinoma, Biochemical indexes, Diagnosis, Surgery

Core tips: In this study, we retrospectively analyzed the clinical and pathological records related with pancreatic mucinous cystadenoma (MCA) and mucinous cystadenocarcinoma (MCC). We found that the MCC tumor size was larger than that of MCA, and age, serum carcinoembryonic antigen, carbohydrate antigen (CA) 19-9, and CA12-5 levels were also higher in MCC patients. As the tumor size of MCA increased, the level of serum CA19-9 also increased. Surgical resection is the primary treatment for MCC and MCA.