Pancreatic Cystic Neoplasms: Diagnosis, Management and Indications for Surgical Procedures. Part II

Bauer, Ferdinand

doi:10.21614/chirurgia.113.3.318

Cited by 4 publications

(9 citation statements)

References 53 publications

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“…Approximately 90% of MCNs occur in middle-aged premenopausal women[ 11 ]. MCNs accounts for approximately 10% of pancreatic cystic lesions, most of which are solitary cystic lesions typically located in distal pancreas[ 12 ] and possess the potential to become MCC.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have drawn different conclusions regarding the specific threshold value of cyst diameter over which the risk of malignancy is increased. It is generally believed that the cyst wall diameter in malignant MCN is usually > 4 cm[ 15 ], or that a diameter of ≥ 6 cm is a risk factor for malignant tumors[ 11 , 16 , 17 ]. In addition, other manifestations suggestive of malignant MCA include peripheral calcification, irregularly contoured cyst walls, thickening of internal septations, increased papillary projections, intracystic nodules, local organ invasion, and vascular obstruction and compression.…”

Section: Discussionmentioning

confidence: 99%

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Clinical diagnosis and management of pancreatic mucinous cystadenoma and cystadenocarcinoma: Single-center experience with 82 patients

Zhao

Jiang

Gao

et al. 2020

WJGO

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical diagnosis and management of pancreatic mucinous cystadenoma and cystadenocarcinoma: Single-center experience with 82 patients

Zhao

Jiang

Gao

et al. 2020

WJGO

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“…Пациенты с доброкачественными MCA имеют средний возраст 50 лет, тогда как у пациентов с муцинозной цистаденокарциномой средний возраст составляет 56 лет [3]. В ряде исследований сообщалось, что пациенты со злокачественными КНПЖ были значимо старше пациентов с доброкачественными КНПЖ [10]. Этот факт также подтверждается результатами нашего исследования.…”

Section: Discussionunclassified

“…К сожалению, на основании существующих клинических рекомендаций диагностика и выбор метода лечения КНПЖ остаются сложной задачей [9]. Предоперационная диагностика КНПЖ в значительной степени зависит от рентгенологических и клинических особенностей, которые зачастую обладают низкой чувствительностью, особенно в случае бессимптомных образований [10]. По данным литературы, даже в крупных специализированных медицинских центрах до одной пятой КНПЖ, диагностируемых как злокачественные на дооперационном этапе, при окончательном морфологическом исследовании оказываются доброкачественными [11].…”

Section: Introductionunclassified

“…В настоящее время для дифференциальной диагностики КНПЖ используются разнообразные диагностические методы визуализации, такие как компьютерная и магнитно-резонансная томография с контрастным усилением (КТ и МРТ), контрастусиленная ультразвуковая диагностика (КУЗИ) и эндоскопическая ультрасонография (ЭУС) с тонкоигольной биопсией и аспирацией кистозного содержимого для дальнейшего цитологического исследования [10]. По данным литературы, КТ, МРТ и КУЗИ имеют практически одинаковую диагностическую точность в характеристике кистозных образований поджелудочной железы [12].…”

Section: Introductionunclassified

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Combined method for differential diagnosis of pancreatic cystic neoplasm

Koshel

Дроздов

Kuznetsova³

et al. 2019

Sib. onkol. ž.

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Objective. The frequency of detection of cystic neoplasm of the pancreas (CNP) has recently increased. Some of these neoplasms are benign, while others are malignant. Differential diagnosis between benign and malignant CNP remains challenging.Aim: to develop a combined method for differential diagnosis of CNP and to evaluate the role of the neutrophil to leukocyte ratio (NLR) as a diagnostic criterion of malignant CNP.Material and Methods. A retrospective analysis of the treatment of 82 patients with CNP, who underwent surgery between 2008 and 2018, was carried out. Benign lesions were detected in 62 patients and malignant tumors were diagnosed in 20 patients. The NLR and the serum levels of CA 19-9 as well as the presence of intracystic lesions were assessed as predictors of malignant CNP.Results. The presence of intracystic lesions detected by contrast-enhanced computed tomography and the elevated levels of serum CA 19-9 (>39 U/mL) and NLI (>1.876) were proven to be independent predictors of malignant CNP with statistical significance. The combination of all three criteria indicated malignant cystic neoplasm. The sensitivity, specificity and overall accuracy of the combined method were 71.4 %, 95.6 % and 86.5%, respectively.Conclusions. The combined method for differential diagnosis of malignant CNP is easy to use and has high accuracy. There is a direct correlation between NLI and malignant CNP.

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2018

GMR

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Pancreatic cystic neoplasm is a group of neoplastic changes in the epithelium of the ducts or parenchyma of the pancreas. This is a complex diagnostic problem of modern medicine. With the improvement of diagnostic methods for pancreatic pathology, the frequency of detection of incidental pancreatic cysts has been increased. Some cystic lesions neoplasms are recognized as precursor of pancreatic adenocarcinoma and requires early surgical treatment, or close observation. The article discusses the issues of classification, the malignant potential and the differential diagnosis of pancreatic cysts.

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Pancreatic Cystic Neoplasms: Diagnosis, Management and Indications for Surgical Procedures. Part II

Cited by 4 publications

References 53 publications

Clinical diagnosis and management of pancreatic mucinous cystadenoma and cystadenocarcinoma: Single-center experience with 82 patients

Clinical diagnosis and management of pancreatic mucinous cystadenoma and cystadenocarcinoma: Single-center experience with 82 patients

Combined method for differential diagnosis of pancreatic cystic neoplasm

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