Gut Microbiota-Brain Axis in Pancreatic Cystic Neoplasms: An Observational Analysis.

OBJECTIVEThis observational analysis aimed to explore the association between gut microbiota and brain axis in pancreatic cysts and assess the impact of this association on clinical outcomes.

METHODOLOGYThis retrospective cohort study was conducted at Dicle University Faculty of Medicine, Diyarbakır, Turkey. Forty-seven patients (serous cystadenoma n=16, mucinous neoplasm n=31) treated at a single center between 2015 to 2023 were included in the study. Microbiota analysis (16S rRNA sequencing) of stool samples, biochemical and hormonal parameters from blood samples were evaluated. Depression-anxiety scales and cognitive tests were also performed.

RESULTSMicrobiota diversity in the mucinous neoplasm group (Shannon index: 2.9±0.6) was significantly lower than in the serous cystadenoma group (3.8±0.5) (p=0.012). Firmicutes/Bacteroidetes ratio (2.89±0.5), inflammatory markers (CRP: 4.2±4.8 mg/dL) and depression scores (Beck: 18.6±6.4) were significantly higher in mucinous neoplasm patients (p<0.05). Two-year overall survival rates were 100% in the serous cystadenoma group and 80% in the mucinous neoplasm group (p=0.015).

CONCLUSIONThe microbiota-brain axis has an important role in pancreatic cysts. Microbiota imbalance, increased inflammation and high depression-anxiety levels observed especially in mucinous neoplasms suggest potential targets for future therapeutic interventions in this patient group.