Abstract

Objective

Guidelines suggest that patients with undiagnosed pancreatic cystic lesions should be monitored despite a lack of evidence supporting surveillance for undiagnosed mucinous cystic neoplasms (MCNs). We aimed to investigate the pre- and post-operative clinical course of patients with MCN and the utility of follow-up for patients who were not diagnosed with MCN at initial examination.

Patients and Methods

This multicenter retrospective study enrolled 28 patients with resected pathology-proven MCN; 12 and 16 patients underwent surgery within and after 6 months from the initial examination (Groups A and B, respectively). Outcome measures included changes in imaging findings until surgery in Group B, pathological findings between both groups and differences in pathological findings between patients with and without regular follow-up imaging in Group B.

Results

In Group B, the median cyst size was 30 and 48 mm at the initial examination and immediately before surgery, respectively. The incidence of mural cysts, thickened walls and mural nodules were 25, 19 and 0%, respectively, at the initial examination and 69, 56 and 31%, respectively, immediately before surgery. There were no significant differences in the invasive carcinoma rates between Groups A and B (13 vs. 17%). Regular follow-up imaging was offered to Group B. Among these, invasive carcinoma was found in one patient exhibiting no recurrence. One patient without follow-up imaging had invasive carcinoma recurrence post-operatively.

Conclusions

MCNs increased in size, and typical imaging findings appeared over time. For undiagnosed MCN, regular follow-up examination contributed to the determination of the appropriate surgical timing.

中文翻译：

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对于未确诊的粘液性囊性肿瘤患者，定期随访影像是否有助于确定合适的手术时机？一项多中心回顾性研究

摘要

客观的

指南建议，尽管缺乏证据支持对未确诊的粘液性囊性肿瘤 (MCN) 进行监测，但仍应监测未确诊胰腺囊性病变的患者。我们旨在调查 MCN 患者的术前和术后临床病程，以及随访对初次检查时未诊断为 MCN 的患者的效用。

患者和方法

这项多中心回顾性研究招募了 28 名经病理证实切除的 MCN 患者；12 和 16 名患者在初次检查后 6 个月内和之后接受了手术（分别为 A 组和 B 组）。结果指标包括 B 组手术前影像学表现的变化、两组之间的病理学表现以及 B 组中定期随访和未定期影像学检查的患者之间病理学表现的差异。

结果

在 B 组中，初始检查和手术前的中位囊肿大小分别为 30 和 48 毫米。初次检查时壁囊肿、壁增厚和壁结节的发生率分别为 25%、19% 和 0%，手术前即刻分别为 69%、56% 和 31%。A 组和 B 组之间的浸润性癌发生率没有显着差异（13% 对 17%）。为 B 组提供定期随访影像。其中，一名患者发现浸润性癌，未复发。一名未进行后续影像学检查的患者在手术后出现浸润性癌复发。

结论

MCN 的大小增加，并且随着时间的推移出现典型的成像结果。对于未确诊的 MCN，定期随访检查有助于确定适当的手术时机。