Endoscopic ultrasound is useful for the risk stratification of mucinous pancreatic cystic lesions: A long-term prospective study.

IF 2.8 2区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Sahar Wesali, Antonio Molinaro, Björn Lindkvist, Per Hedenström, Riadh Sadik
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引用次数: 0

Abstract

Objectives: The aims of this prospective observational study were to test worrisome features on endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) as a stratification tool in patients with mucinous pancreatic cystic lesions (PCLs), and to assess these patients' long-term risk of adenocarcinoma and mortality.

Methods: Patients with suspected PCLs on cross-sectional imaging who underwent EUS-FNA at Sahlgrenska University Hospital between February 2007 and February 2018 were consecutively enrolled. The main inclusion criterion was the final diagnosis of a mucinous PCL. The results from EUS-FNA were analyzed in the context of outcome gathered from medical records of follow-up until February 2021.

Results: Of 334 patients undergoing EUS-FNA, 171 (51 %) had a final diagnosis of a mucinous PCL. 29/171 (17 %) patients were diagnosed with HGD or adenocarcinoma <6 months after EUS-FNA, with 28/29 (97 %) patients having at least one worrisome feature on EUS-FNA. A solid component in mucinous PCLs on EUS was independently associated with the presence of HGD or adenocarcinoma (OR 23.6, 95 % CI 6.1-91.6, p < .001). A total of 4/142 (3 %) patients developed adenocarcinoma during the follow-up period (median = 61.4 months). Overall, in 80/82 (98 %) of the patients without worrisome features on EUS-FNA, HGD or adenocarcinoma was not detected. Six of the 21 (29 %) patients with HGD or adenocarcinoma who underwent surgery as initial management died from pancreatic cancer during follow-up.

Conclusions: EUS-FNA is useful for the risk stratification of mucinous PCLs. The low incidence of adenocarcinoma over time after a negative EUS-FNA may allow for a less resource intensive surveillance strategy.

内镜超声对胰腺粘液性囊性病变的风险分层是有用的:一项长期前瞻性研究。
目的:本前瞻性观察性研究的目的是检测超声内镜引导下细针穿刺(EUS-FNA)作为胰腺粘液性囊性病变(pcl)患者分层工具的令人担忧的特征,并评估这些患者患腺癌和死亡的长期风险。方法:连续入选2007年2月至2018年2月在萨尔格伦斯卡大学医院行EUS-FNA的横断面成像疑似pcl患者。主要的入选标准是最终诊断为粘液性PCL。EUS-FNA的结果与从随访到2021年2月的医疗记录中收集的结果进行了分析。结果:在334例接受EUS-FNA的患者中,171例(51%)最终诊断为粘液性PCL。结论:EUS-FNA可用于黏液性pcl的风险分层。EUS-FNA阴性后一段时间内腺癌的低发病率可能允许较少资源密集的监测策略。
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来源期刊
Pancreatology
Pancreatology 医学-胃肠肝病学
CiteScore
7.20
自引率
5.60%
发文量
194
审稿时长
44 days
期刊介绍: Pancreatology is the official journal of the International Association of Pancreatology (IAP), the European Pancreatic Club (EPC) and several national societies and study groups around the world. Dedicated to the understanding and treatment of exocrine as well as endocrine pancreatic disease, this multidisciplinary periodical publishes original basic, translational and clinical pancreatic research from a range of fields including gastroenterology, oncology, surgery, pharmacology, cellular and molecular biology as well as endocrinology, immunology and epidemiology. Readers can expect to gain new insights into pancreatic physiology and into the pathogenesis, diagnosis, therapeutic approaches and prognosis of pancreatic diseases. The journal features original articles, case reports, consensus guidelines and topical, cutting edge reviews, thus representing a source of valuable, novel information for clinical and basic researchers alike.
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