{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T19:58:58Z","timestamp":1789588738410,"version":"build-2803163510"},"reference-count":33,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,12,28]],"date-time":"2017-12-28T00:00:00Z","timestamp":1514419200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>The aim of this study is to elucidate the natural history of pancreatic cystic lesions (PCLs), including branch duct\u2010type intraductal papillary mucinous neoplasm (BD\u2010IPMN), via midterm follow\u2010up analysis of a multicenter prospective observational study (NSPINAL study).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From July 2011 to October 2016, 881 patients with PCLs were enrolled in NSPINAL study, and 664 patients with &gt;\u00a012\u00a0months of follow up were analyzed. Every patient was asymptomatic, and endoscopic ultrasound was performed at the initial diagnosis to exclude high\u2010risk individuals. Follow up included endoscopic ultrasound, computed tomography, or magnetic resonance imaging at least once a year. Serial morphological changes and the pancreatic cancer (PC) incidence, including malignant progression of PCLs, were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The 664 patients (358 men) were followed for a median of 33.5\u00a0months (interquartile range 29). The cyst and main pancreatic duct sizes were 16.6\u00a0\u00b1\u00a09.3 and 2.3\u00a0\u00b1\u00a01.0\u00a0mm, respectively. Morphologically, 518 cases were multilocular, 137 were unilocular, and 9 had a honeycomb pattern; 269 cases involved multifocal lesions. Ninety\u2010six patients (14.5%) showed worsening progression on imaging. There were two resectable and four unresectable cases of pancreatic ductal adenocarcinoma and three cases of malignant BD\u2010IPMN. The 3\u2010year risk of developing PC was 1.2%. The standardized incidence ratio for PC among PCLs was 10.0 (95% confidence interval 3.5\u201316.5), and the standardized incidence ratio among BD\u2010IPMN was 16.6 (95% confidence interval 5.1\u201328.1). Multivariate analysis showed that development of symptoms and worsening progression were significant predictors of PC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Malignant progression of PCLs, including PC development, is not uncommon. Patients with PCLs should be carefully monitored to detect pancreatic ductal adenocarcinoma at early stages.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.13967","type":"journal-article","created":{"date-parts":[[2017,9,5]],"date-time":"2017-09-05T11:45:51Z","timestamp":1504611951000},"page":"320-328","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":63,"title":["Natural history of pancreatic cystic lesions: A multicenter prospective observational study for evaluating the risk of pancreatic cancer"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7730-4630","authenticated-orcid":false,"given":"Eizaburo","family":"Ohno","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nagoya University Graduate School of Medicine  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9639-7425","authenticated-orcid":false,"given":"Yoshiki","family":"Hirooka","sequence":"additional","affiliation":[{"name":"Department of Endoscopy Nagoya University Hospital  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1223-8756","authenticated-orcid":false,"given":"Hiroki","family":"Kawashima","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nagoya University Graduate School of Medicine  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5814-3555","authenticated-orcid":false,"given":"Takuya","family":"Ishikawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nagoya University Graduate School of Medicine  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Kanamori","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Ogaki Municipal Hospital  Ogaki Gifu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideki","family":"Ishikawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Public Nishichita General Hospital  Tokai Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoji","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Konan Kousei Hospital  Konan Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Nonogaki","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Daido Hospital  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2744-7182","authenticated-orcid":false,"given":"Kazuo","family":"Hara","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Aichi Cancer Centre Hospital  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3581-2004","authenticated-orcid":false,"given":"Senju","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Fujita Health University  Toyoake Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Matsubara","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Toyohashi Municipal Hospital  Toyohashi Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takanori","family":"Hirai","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Komaki Municipal Hospital  Komaki Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajime","family":"Sumi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Japanese Red Cross Nagoya Daiichi Hospital  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Sugimoto","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Handa City Hospital  Handa Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8389-1416","authenticated-orcid":false,"given":"Hidemi","family":"Goto","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nagoya University Graduate School of Medicine  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"NSPINAL study group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,12,28]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"348","article-title":"Four cases of mucous secreting pancreatic cancer (Japanese)","volume":"20","author":"Ohashi K","year":"1982","journal-title":"Prog. 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