Small and Stable Pancreatic Cysts Are Reassuring During Surveillance: Results From the PACYFIC Trial

作者：Iris J. M. Levink, Marloes L. J. A. Sprij, Brechtje D.M. Koopmann, Jihane Meziani, Sanne C. Jaarsma, Priscilla A. van Riet, Kasper A. Overbeek, Myrte Gorris, Rogier P. Voermans, Jeanin Elise van Hooft, Riccardo Casadei, Mariacristina Di Marco, Michael B. Wallace, Sanne A.M. Hoogenboom, Neville Azopardi, Reea Ahola, Marcin Polkowski, Pieter Honkoop, Silvia Carrara, Erik J. Schoon, Niels G. Venneman, Laurens A. van der Waaij, Anne‐Marie van Berkel, Gemma Rossi, Jilling F. Bergmann, Elizabeth Pando, Georg Beyer, Matthijs P. Schwartz, Frederike G.I. van Vilsteren, Chantal V. Hoge, Marianne E. Smits, Rutger Quispel, Ellert J. van Soest, Patrick M. Vos, Robert C. Verdonk, Toon Steinhauser, Eva Kouw, Adriaan C.I.T.L. Tan, László Czakó, Marco J. Bruno, Djuna L. Cahen, PACYFIC‐Study Work Group · 发表于：United European Gastroenterology Journal · 年份：2025 · DOI：10.1002/ueg2.70043 · 被引用次数：9 · 研究领域：Pancreatic and Hepatic Oncology Research、Pancreatitis Pathology and Treatment、Cystic Fibrosis Research Advances

BACKGROUND: Pancreatic cysts are increasingly discovered on imaging studies performed for unrelated conditions. Currently, surveillance of these lesions poses a substantial burden on patients, and health care recourses. We hypothesized that individuals with small and stable cysts have a diminutive risk of progressing to high-grade dysplasia (HGD) or pancreatic cancer (PC) that is similar to that in the general population. METHODS: This nested PACYFIC-study is a collaboration among 44 centers in Europe and Northern-America, and investigates the risk of HGD and PC for different cyst sizes and growth rates in participants without baseline worrisome features (WF) or high-risk stigmata (HRS). RESULTS: Of the 2369 PACYFIC participants, 975 met the inclusion criteria, with a mean age of 67 years (SD 13) and 65% being female. Of these, 438 individuals (45%) had a baseline small cyst size (< 15 mm), and 885 (91%) individuals had a slow growth rate (< 2.5 mm/year). During a median follow-up of 45 months (IQR 27), 20 individuals (2.1%) developed HGD, or PC. Individuals with small cysts had a 1.5-fold lower risk of developing WF or HRS (hazard ratio [HR] 0.7 [0.5-1.0], p = 0.03) than those with larger cysts but a similar risk of developing HGD or PC (p > 0.05). Slow growth was protective against the development of WF or HRS (HR 0.4 [0.2-0.6], p < 0.001) and HGD or PC (HR 0.04 [95% CI 0.02-0.12], p < 0.001). Individuals with small, stable sized cysts without baseline WF or HRS did not hav...