Determination of Malignant and Invasive Predictors in Branch Duct Type Intraductal Papillary Mucinous Neoplasms of the Pancreas: A Suggested Scoring Formula.
10.3346/jkms.2011.26.6.740
- Author:
Dae Wook HWANG
1
;
Jin Young JANG
;
Chang Sup LIM
;
Seung Eun LEE
;
Yoo Seok YOON
;
Young Joon AHN
;
Ho Seong HAN
;
Sun Whe KIM
;
Sang Geol KIM
;
Young Kook YUN
;
Seong Sik HAN
;
Sang Jae PARK
;
Tae Jin LIM
;
Koo Jung KANG
;
Mun Sup SIM
;
Seong Ho CHOI
;
Jin Seok HEO
;
Dong Wook CHOI
;
Kyung Yul HUR
;
Dong Shik LEE
;
Sung Su YUN
;
Hong Jin KIM
;
Chul Kyoon CHO
;
Hyun Jong KIM
;
Hee Chul YU
;
Baik Hwan CHO
;
In Sang SONG
Author Information
1. Department of Surgery, and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea. jangjy4@snu.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Branch Duct Type Intraductal Papillary Mucinous Neoplasm (IPMN);
Cyst Size;
Mural Nodule;
CEA;
Malignancy;
Invasive Carcinoma
- MeSH:
Adenocarcinoma, Mucinous/*pathology;
Adult;
Aged;
Aged, 80 and over;
Carcinoembryonic Antigen/blood;
Carcinoma, Pancreatic Ductal/*pathology;
Carcinoma, Papillary/*pathology;
Female;
Humans;
Magnetic Resonance Imaging;
Male;
Middle Aged;
Multivariate Analysis;
Neoplasm Invasiveness;
Neoplasm Staging;
Pancreatic Neoplasms/*pathology;
Predictive Value of Tests;
ROC Curve;
Tomography, X-Ray Computed
- From:Journal of Korean Medical Science
2011;26(6):740-746
- CountryRepublic of Korea
- Language:English
-
Abstract:
Prediction of malignancy or invasiveness of branch duct type intraductal papillary mucinous neoplasm (Br-IPMN) is difficult, and proper treatment strategy has not been well established. The authors investigated the characteristics of Br-IPMN and explored its malignancy or invasiveness predicting factors to suggest a scoring formula for predicting pathologic results. From 1994 to 2008, 237 patients who were diagnosed as Br-IPMN at 11 tertiary referral centers in Korea were retrospectively reviewed. The patients' mean age was 63.1 +/- 9.2 yr. One hundred ninty-eight (83.5%) patients had nonmalignant IPMN (81 adenoma, 117 borderline atypia), and 39 (16.5%) had malignant IPMN (13 carcinoma in situ, 26 invasive carcinoma). Cyst size and mural nodule were malignancy determining factors by multivariate analysis. Elevated CEA, cyst size and mural nodule were factors determining invasiveness by multivariate analysis. Using the regression coefficient for significant predictors on multivariate analysis, we constructed a malignancy-predicting scoring formula: 22.4 (mural nodule [0 or 1]) + 0.5 (cyst size [mm]). In invasive IPMN, the formula was expressed as invasiveness-predicting score = 36.6 (mural nodule [0 or 1]) + 32.2 (elevated serum CEA [0 or 1]) + 0.6 (cyst size [mm]). Here we present a scoring formula for prediction of malignancy or invasiveness of Br-IPMN which can be used to determine a proper treatment strategy.
