Clinical and pathological characteristics of 595 patients with PCs and correlation with KRAS, GNAS and VHL status
| Patient or cyst characteristics | Total | KRAS and/or GNAS | p Value | VHL | p Value | ||
| Wild type | Mutant | Wild type | Mutant | ||||
| Gender | n=595 | ||||||
| Woman | 341 | 181 (53%) | 160 (47%) | 0.246 | 308 (90%) | 33 (10%) | 0.067 |
| Man | 254 | 122 (48%) | 132 (52%) | 240 (94%) | 14 (6%) | ||
| Mean age (range) (years) | 65.0 (15–93) | 60.7 (15–90) | 69.4 (34–93) | <0.001 | 65.2 (15–93) | 62.3 (33–81) | 0.122 |
| Symptomatic presentation | 198 | 112 (57%) | 86 (43%) | 0.056 | 189 (95%) | 9 (5%) | 0.036 |
| Location | n=626 | ||||||
| Head, neck and uncinate | 320 | 137 (43%) | 183 (57%) | <0.001 | 299 (92%) | 21 (7%) | 0.368 |
| Body and tail | 306 | 181 (59%) | 125 (41%) | 280 (92%) | 26 (8%) | ||
| Mean cyst size (range) (cm) | 2.7 (0.8–21.0) | 3.0 (0.8–21.0) | 2.4 (0.8–11.0) | <0.001 | 2.7 (0.8–21.0) | 3.2 (1.0–8.9) | 0.060 |
| Cyst multifocality | 281 | 95 (34%) | 186 (66%) | <0.001 | 270 (96%) | 11 (4%) | 0.002 |
| Increased fluid viscosity | 319 | 85 (27%) | 234 (73%) | <0.001 | 316 (99%) | 3 (1%) | <0.001 |
| CEA >192 ng/mL (n=452)* | 146 | 38 (26%) | 108 (74%) | <0.001 | 146 (100%) | 0 (0%) | <0.001 |
| Satisfactory cytological adequacy | 251 | 117 (47%) | 134 (53%) | 0.088 | 236 (94%) | 15 (6%) | 0.279 |
| Diagnostic pathology | n=102 | n=43 | n=59 | n=100 | n=2 | ||
| Adenocarcinoma arising in an IPMN | 13 | 0 (0%) | 13 (100%) | 13 (100%) | 0 (0%) | ||
| IPMN with low-grade/high-grade dysplasia | 43 | 0 (0%) | 43 (100%) | <0.001† | 43 (100%) | 0 (0%) | |
| MCN with low-grade/high-grade dysplasia | 10 | 7 (70%) | 3 (30%) | 10 (100%) | 0 (0%) | ||
| Serous cystadenoma | 3 | 3 (100%) | 0 (0%) | 1 (33%) | 2 (67%) | <0.001‡ | |
| Cystic PanNET | 9 | 9 (100%) | 0 (0%) | 9 (100%) | 0 (0%) | ||
| Acinar cell cystadenoma | 1 | 1 (100%) | 0 (0%) | 1 (100%) | 0 (0%) | ||
| Pseudocyst | 17 | 17 (100%) | 0 (0%) | 17 (100%) | 0 (0%) | ||
| Retention cyst | 2 | 2 (100%) | 0 (0%) | 2 (100%) | 0 (0%) | ||
| Lymphoepithelial cyst | 2 | 2 (100%) | 0 (0%) | 2 (100%) | 0 (0%) | ||
| Epidermoid cyst | 1 | 1 (100%) | 0 (0%) | 1 (100%) | 0 (0%) | ||
| Squamoid cyst | 1 | 1 (100%) | 0 (0%) | 1 (100%) | 0 (0%) | ||
*Sufficient PCF for CEA analysis was available for 127 (80%) PCs.
†Follow-up NGS testing for KRAS and GNAS was performed for 24 (15%) PCs.
‡p Value corresponds to SCA versus other PCs.
CEA, carcinoembryonic antigen; IPMN, intraductal papillary mucinous neoplasm; MCN, mucinous cystic neoplasm; PanNET, pancreatic neuroendocrine tumour; PC, pancreatic cyst; PCF, pancreatic cyst fluid; SCA, serous cystadenomas.