Clinicopathological features of pancreatic mucinous cystic neoplasm and influencing factors for its malignancy

Objective To investigate the clinicopathological features of pancreatic mucinous cystic neoplasm ( MCN) and influencing factors for benign and malignant MCN. Methods A retrospective analysis was performed for the clinical data of 43 patients with pathologically confirmed pancreatic MCN who were treated from January 2013 to December 2015, and according to the results of pathological diagnosis, the patients were divided into benign group ( mucinous cystadenoma and pancreatic MCN with low/middle-grade dysplasia) and malignant group ( MCN with high-grade dysplasia and MCN with invasive carcinoma) . The clinicopathological features and radiological features were summarized, and the risk factors for malignant transformation of pancreatic MCN were analyzed. The independent samples t-test was used for comparison of continuous data between groups, the chi-square test was used for comparison of categorical data between groups, and a multivariate logistic regression analysis was used to identify risk factors. Results There were 14 male and 29 female patients aged 22-81 years ( median 58. 53 years) . Of all patients, 30 ( 69. 8%) had clinical symptoms. The maximum tumor diameter was 4. 8 cm ( range 1. 2-16cm) . Of all patients, 18 ( 41. 9%) had MCN in the head of the pancreas, 3 ( 7. 0%) had MCN in the neck of the pancreas, 20 ( 46. 5%) had MCN in the body and tail of the pancreas, and 2 ( 4. 6%) had multiple MCNs. There were significant differences between the two groups in age, tumor nature, tumor location, texture, tumor markers, heterogeneous enhancement of the cyst wall, heterogeneous enhancement of solid components, and cyst wall thickness > 0. 2 cm ( all P < 0. 05) . The multivariate logistic regression analysis showed that age and increased tumor markers were independent predictive factors for malignant pancreatic MCN ( both P < 0. 05) . Conclusion Age, tumor nature, tumor location, texture, increased tumor markers, heterogeneous enhancement of the cyst wall, heterogeneous enhancement of solid components, and cyst wall thickness > 0. 2 cm are important features of malignant pancreatic MCN, and age and increased tumor markers are risk factors for malignant pancreatic MCN.