Natural History of Pancreatic Cysts

Larson, Alexander; Kwon, Richard S.

doi:10.1007/s10620-017-4542-x

Cited by 6 publications

(5 citation statements)

References 98 publications

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“…Moreover, most IPMNs are BD-type (88.4%), and pure main duct type accounts for 4% in this study. As a result of the changes in the medical environment, the management of IPMN has shifted more toward watchful surveillance, [30][31][32] whereas surgery is recommended for MD-IPMN and mixedtype IPMN. 12,[33][34][35] Careful nonsurgical surveillance is generally suggested for BD-IPMN.…”

Section: Discussionmentioning

confidence: 99%

Natural history and optimal treatment strategy of intraductal papillary mucinous neoplasm of the pancreas: Analysis using a nomogram and Markov decision model

Han

Jang

et al. 2020

J Hepato Biliary Pancreat

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Background/Purpose: With the increase in detection of intraductal papillary mucinous neoplasms (IPMN), a tailored approach is needed. This study was aimed at exploring the natural history of IPMN and suggest optimal treatment based on malignancy risk using a nomogram and Markov decision model. Methods: Patients with IPMN who underwent surveillance or surgery were included. Changes in worrisome features/high-risk stigmata and malignancy conversion rate were assessed. Life expectancy and quality-adjusted life year (QALY) were compared using a nomogram predicting malignancy. Results: Overall, 2006 patients with histologically confirmed or radiologically typical IPMN were enrolled. Of these, 1773 (88.4%), 81 (4.0%), and 152 (7.6%), respectively, had branch duct (BD)-, main duct-, and mixed-type IPMN at initial diagnosis. The cumulative risk of developing worrisome feature or high-risk stigmata was 19.0% and 35.0% at 5-and 10-year follow-up, respectively. The progression of malignancy rate at 10-year follow-up was 79.9% for main and mixed IPMNs and 5.9% for BD-IPMN. Nomogram-based malignancy risk prediction is well correlated with natural history based on pathologic biopsy and shows good stratification of survival. The decision model recommends surgery to maximize survival and QALY especially in those with >35% malignancy risk. Conclusions: Compared with main duct-and mixed-type IPMN, which have a high risk of malignancy (79.9%), BD-IPMN is very indolent (5.9%). The nomogram-based decision model suggests surgery rather than surveillance for patients with a high malignancy risk. The optimal treatment strategy between surgery and surveillance should consider patients' health status, malignancy risk, and centers' experience.

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Section: Discussionmentioning

confidence: 99%

Natural history and optimal treatment strategy of intraductal papillary mucinous neoplasm of the pancreas: Analysis using a nomogram and Markov decision model

Han

Jang

et al. 2020

J Hepato Biliary Pancreat

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“…It is expected to become the second leading cause of cancer-related deaths in the United States in the next few years. Peak incidence of pancreatic cancer has been linked to few predisposing factors, including cigarette smoking, red meat, obesity, and heavy alcohol consumption along with pancreatic disease [34] , [35] , [36] . Because of its aggressive behavior and frequently late diagnosis, research aiming at early diagnosis of pancreatic cancer or its precursors is crucial.…”

Section: Discussionmentioning

confidence: 99%

Identification of Prognostic Biomarkers by Combined mRNA and miRNA Expression Microarray Analysis in Pancreatic Cancer

Liu

Yang

Taher

et al. 2018

Translational Oncology

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Pancreatic cancer is the fourth leading cause for cancer-related death, and early diagnosis is one key to improve the survival rate of this disease. Molecular biomarkers are an important method for diagnostic use in pancreatic cancer. We used data from three mRNA microarray datasets and a microRNA dataset (GSE16515, GSE15471, GSE28735, and GSE41372) to identify potential key genes. Differentially expressed genes (DEGs) and microRNAs (DEMs) were identified. Functional, pathway enrichment, and protein-protein interaction analyses were performed on common DEGs across all datasets. The target genes of the DEMs were identified. DEMs targets that were also DEGs were further scrutinized using overall survival analysis. A total of 236 DEGs and 21 DEMs were identified. There were a total of four DEGs (ECT2, NR5A2, NRP2, and TGFBI), which were also predicted target genes of DEMs. Overall survival analysis showed that high expression levels of three of these genes (ECT2, NRP2, and TGFBI) were associated with poor overall survival for pancreatic cancer patients. The basic expression of DEGs in pancreas stood lower level in various organ tissues. The expression of ECT2 and NRP2 was higher in different pancreatic cancer cell lines than normal pancreas cell line. Knockout of ECT2 by Crispr Cas9 gene editing system decreased proliferation and migration ability in pancreatic cancer cell line MiaPaCa2. In conclusion, we think that data mining method can do well in biomarker screening, and ECT2 and NRP2 can play as potential biomarker or therapy target by Crispr Cas9 in pancreatic cancer.

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“…Необходимо отметить, что течение большинства кист ПЖ индолентное. Часто симптомными являются муцинозные цистаденомы [8]. В ряде случаев обструкция протока муцином и последующий его разрыв могут вызывать клиническую картину острого панкреатита [9].…”

Section: Abstract: Pancreas сYstic Tumor Radiomicsunclassified

“…Также не существует биомаркера, который бы точно дифференцировал муцинозную цистаденому от ВПМО 2-го типа [8].…”

Section: Abstract: Pancreas сYstic Tumor Radiomicsunclassified

Preconditions for radiomics-based approach in differential diagnosis of pancreatic cystic lesions: critical evaluation of meta-analyses and international guidelines

Kovalenko,

Karmazanovsky

2023

Lučevaâ diagn. ter.

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INTRODUCTION: Pancreatic cystic lesions (PCLs) are a heterogenous group of lesions ranging from benign to malignant with variable histological, pathomorphological and prognostic characteristics. The development and improvement of radiation methods provides a great opportunity to diagnose such neoplasms. However, there are still difficulties in differential diagnosis and prediction malignant potential in pancreatic cyst subtypes due to their similar radiation characteristics.OBJECTIVE: To determine the diagnostic performane and difficulties of differentiating PCLs by invasive and non-invasive radiological methods. To determine the preconditions for radiomics-based approach in differential diagnosis of pancreatic cystic lesions based on a review and analysis of international guidelines.MATERIALS AND METHODS: We searched for scientific publications in the PubMed and Springer information and analytical systems for 2009–2023 by keywords: «pancreatic tumors», «pancreatic cyst», «pancreatic cystic lesion», «pancreatic radiomics», «intraductal papillary mucinous neoplasm», «pancreatic cystadenoma». As a result, 49 articles were selected for analysis.RESULTS: Despite the high potential of modern non-invasive radiation methods in the detection of pancreatic cysts, differentiation of PCLs subtypes is still very difficult. Due to the variability of international guidelines and a lack of their specificity, there is no universal consensus for management PCLs. In this regard, introduction new alternative diagnostic methods and markers is an important direction of research. At the moment, the assessment of the malignant potential of PCLs is comes down to only two main signs — the main pancreatic duct diameter and the vascularized solid component.CONCLUSION: Currently, common semiotic features, limitations of invasive diagnostic methods and increasing risks of recurrence and malignancy dictate the need to apply new diagnostic approaches to evaluation of PCLs. Searching and introduction new markers will allow us to analyze the lesion structure, to stratify risks and long-term prognosis more accurately. Textural image analysis is a new and promising noninvasive method with high power. This tool plays an important role to estimate those structural parameters which are impossible to judge according to the standard radiologic features, and to offset the problems of traditional diagnostic approach.

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Natural History of Pancreatic Cysts

Cited by 6 publications

References 98 publications

Natural history and optimal treatment strategy of intraductal papillary mucinous neoplasm of the pancreas: Analysis using a nomogram and Markov decision model

Natural history and optimal treatment strategy of intraductal papillary mucinous neoplasm of the pancreas: Analysis using a nomogram and Markov decision model

Identification of Prognostic Biomarkers by Combined mRNA and miRNA Expression Microarray Analysis in Pancreatic Cancer

Preconditions for radiomics-based approach in differential diagnosis of pancreatic cystic lesions: critical evaluation of meta-analyses and international guidelines

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