Predictors of malignancy in pure branch duct type intraductal papillary mucinous neoplasm of the pancreas: A nationwide multicenter study
- Authors
- Kim, Tae Hyeon; Song, Tae Jun; Hwang, Jin-hyeok; Yoo, Kyo-sang; Lee, Woo-jin; Lee, Kwang-hyuck; Dong, Seok-ho; Park, Chang-hwan; Park, Eun-taek; Moon, Jong-ho; Kim, Ho-gak; Kim, Eun-young; Cho, Kwang Bum; Kim, Hong-ja; Lee, Seung-ok; Cheon, Young Koog; Lee, Jeong Mi; Oh, Dong Wook; Kim, Myung-Hwan
- Issue Date
- Jul-2015
- Publisher
- S. Karger AG
- Keywords
- Branch duct type intraductal papillary mucinous neoplasm; Malignancy; Endoscopic ultrasonography; Multicenter study; Risk factors; Pancreas
- Citation
- Pancreatology, v.15, no.4, pp 405 - 410
- Pages
- 6
- Journal Title
- Pancreatology
- Volume
- 15
- Number
- 4
- Start Page
- 405
- End Page
- 410
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/10521
- DOI
- 10.1016/j.pan.2015.04.010
- ISSN
- 1424-3903
1424-3911
- Abstract
- Background/Objectives: Prediction of malignancy in patients with BD-IPMNs is critical for the management. The aim of this study was to elucidate predictors of malignancy in patients with 'pure' BD-IPMNs who had a main pancreatic duct (MPD) diameter of <= 5 mm according to the most recent international consensus criteria and in whom MPD involvement was excluded on postoperative histology. Methods: We identified 177 patients with 'pure' BD-IPMNs based on preoperative imaging and postoperative histology from 15 tertiary referral centers in Korea. BD-IPMNs with low-grade (n = 72) and moderate-grade (n = 66) dysplasia were grouped as benign and BD-IPMNs with high-grade dysplasia (n = 10) and invasive carcinoma (n = 29) were grouped as malignancy. Results: On univariate analysis, particular symptoms (jaundice and clinical pancreatitis), CT findings (cyst size > 3 cm, the presence of enhancing mural nodules) and EUS features (the presence of mural nodules, the mural nodule size > 5 mm) were significant risk factors predicting malignant BD-IPMNs. Multivariate analysis revealed that the cyst size > 3 cm (odds ratio = 9.9), the presence of enhancing mural nodules on CT (odds ratio = 19.3) and the mural nodule size > 5 mm on EUS (odds ratio = 14.9) were the independent risk factors for the presence of malignancy in BD-IPMNs (p < 0.001). Conclusions: The cyst size > 3 cm, the presence of enhancing mural nodules on Cl, the mural nodule size > 5 mm on EUS are three independent predictors of malignancy in patients with 'pure' BD-IPMNs. Copyright (C) 2015, IAP and EPC. Published by Elsevier India, a division of Reed Elsevier India Pvt. Ltd. All rights reserved.
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