Natural history of pancreatic mucinous cystic neoplasms.

Abstract

e21115 Background: Pancreatic cysts (PC) are increasingly being detected; proper management requires a balance between aggressive intervention and surveillance. Mucinous cysts may develop adenocarcinoma; however, only a minority will do so. To better understand the evolution of mucinous cystic neoplasms, we studied the natural history of PC by integrating molecular analyses of cyst fluid with other clinical parameters in a continuous series of patients with extended follow-up. Methods: A continuous series of 299 patients with pancreatic cysts yielded 43 mucinous cysts with one or more ASGE criteria and/or risk factors for cancer formation. Patients with overt pancreatic cancer were excluded. Molecular analyses measured 1) DNA quantity, 2) DNA quality, 3) Kras point mutation, 4) allelic imbalance (loss of heterozygosity [LOH]) for 16 markers, and 5) degree of clonal expansion of DNA alterations (RedPath PathFinderTG). Follow up ranged from 25 to 45 months. Results: Of 43 patients predicted to be non-malign...