The current status of diagnosis and treatment of pancreatic cystic neoplasm in China: a report of 2 251 cases / 中华外科杂志

ABSTRACT

To analyze the current status of diagnosis and treatment of pancreatic cystic neoplasm(PCN)in China. Clinical data of 2 251 PCN patients who underwent surgical resection from January 2006 to December 2016 in 16 institutions was retrospectively analyzed.Excel database was created which covered 132 fields of 7 fields: general information of patients, imaging findings, preoperative blood biochemical indexes, tumor markers, surgical related data, postoperative complications and pathology. Of the 2 251 patients, the male to female ratio was 1.0 to 2.4, and the mean age at diagnosis was 47.5 years(range, 8-89 years). Solid pseudo-papillary tumor(SPT), Serouscystic neoplasm(SCN), Intraductal papillary mucinous neoplasm(IPMN), mucinous cystic neoplasm(MCN) were 713 cases, 678 cases, 495 cases, 365 cases, respectively; and the malignant transformation rate was 12.3%, 0.6%, 32.1%, 10.4%, respectively. Carcinoembryonic antigen, CA19-9, CA125 were significantly increased in the malignant group.The incidence of postoperative complications in SCN was the highest.Preoperative CT scan was the most common method in China.The characteristics of IPMN included atrophy of pancreas body and tail, dilatation of the main pancreatic duct, and pancreatitis, and these characteristics were three to six times more than other 3 kinds of PCN.The correct rate of preoperative diagnosis to subtype was 33.0%. SPT is the most common tumor in all PCN in China.One of the key research directions is to improve the accuracy of subtype diagnosis to avoid unnecessary surgery.