Su1464 Features Associated With Interval Progression of Small Pancreatic Cystic Lesions - A Retrospective Study

Abstract

Background Small pancreatic cystic lesions without concerning findings such as mural nodule are advised to undergo surveillance. However, they can trigger significant anxiety for patients and their physicians. We aimed to investigate the progression of pancreatic cystic lesion and find if any clinical and imaging features that might be associated with the progression. Patients and Methods Patients with pancreatic cystic lesions other than pseudocyst detected incidentally by sonography, computed tomography, or magnetic resonance imaging with at least one year follow-up were retrospectively enrolled. Cystic lesions larger than 3 cm in size or had solid component or accompanied with dilated pancreatic duct more than 5mm were excluded. The interval progression of cystic lesions was checked and the rate of change was determined. The clinical features of patients and imaging characteristics were compared between the patients with and without progression of pancreatic cystic lesion. Results In total, 166 patients were enrolled. The mean follow-up period was 4.3 ± 2.3 years (range 1.0 to 10.1 years) and the mean progression was 0.8 ± 1.3 mm/ year (range 0 to 6.1 mm). One hundred and seven patients had interval progression of pancreatic cystic lesion. These patients were further divided into two nearly equal groups, the minimal change group (n = 53) and the progression group (n = 54), by using a progression rate less or more than 1 mm/year. Regarding to the imaging features, tubular component, septation, or dilated pancreatic duct were more frequently associated with progressive pancreatic cystic lesions than minimal changed or unchanged lesions (p < 0.05). Compared to the unchanged lesions, the pancreatic cystic lesions were likely to be progressive if they had septation (OR 4.534, 95% CI: 1.384 14.852, p = 0.013) or tubular components (OR 4.247, 95% CI: 1.312 13.748, p = 0.016). Besides, patients with progressive cystic lesion were older than the other patients (p < 0.05). Conclusions Small pancreatic cystic lesion progressed slowly. However, lesions with tubular component, septation or pancreatic duct dilation may be related to mucinous neoplasm and therefore, were more apt to be progressive. Presence of these imaging features and together with an older age of patients may require a shorter surveillance interval. Clinical and Imaging Characteristic of Patients