Predictive factors for invasive intraductal papillary mucinous neoplasm of the pancreas
Open Access
- 1 January 2011
- journal article
- Published by The Korean Association of Hepato-Biliary-Pancreatic Surgery in Korean Journal of Hepato-Biliary-Pancreatic Surgery
- Vol. 15 (4), 237-242
- https://doi.org/10.14701/kjhbps.2011.15.4.237
Abstract
Intraductal papillary mucinous neoplasm (IPMN) of the pancreas has malignant potential. Predicting invasive IPMN has proven difficult and controversial. We tried to identify predictive factors for invasive IPMN. Thirty six patients underwent resection for IPMN from February 2001 to July 2011. Clinicopathological features including demographic, imaging, microscopic, and serological findings were retrospectively reviewed. Receiver operating characteristic (ROC) curve analysis was used to analyze sensitivity and specificity of all possible cut-off values for the diameter of the main pancreatic duct and mass size predicting invasive IPMN. Student t-test, chi-square test, and logistic regression were used for univariate and multivariate analysis. The mean age was 63.5±8.4 years. Males were more commonly affected (58.3% vs 41.7%). Pancreaticoduodenectomy was performed in 55.6% of patients, distal pancreatectomy in 36.1%, and central pancreatic resection in 8.3%. Non-invasive IPMNs were present in 80.6% (n=29), whereas invasive IPMNs were present in 19.4% (n=7). In univariate analysis, tumor location (p=0.036), Kuroda classification (p=0.048), mural nodule (p=0.016), and main duct dilatation (≥8 mm) (p=0.006) were statistically significant variables. ROC curve analysis showed that a value of 8 mm for the main duct dilatation and a value of 35 mm for the size of the mass lesion have 80% sensitivity and 75% specificity and 100% sensitivity and 82.6% specificity, respectively. However, in multivariate analysis, main ductal dilatation (≥8 mm) was identified to be the only independent factor for invasive IPMN (p=0.049). Main duct dilatation appears to be a useful indicator for predicting invasive IPMN.Keywords
This publication has 20 references indexed in Scilit:
- Intraductal Papillary Mucinous Neoplasm of the Pancreas: Assessment of the Likelihood of Invasiveness with Multisection CTRadiology, 2008
- Intraductal papillary mucinous tumour of the pancreas: differentiation of malignancy and benignancy by CTClinical Radiology, 2006
- Intraductal Papillary Mucinous Neoplasm of Pancreas: Multi–Detector Row CT with 2D Curved Reformations—Correlation with MRCPRadiology, 2006
- Cystic, mucin-producing neoplasms of the pancreas: the distinguishing features of mucinous cystic neoplasms and intraductal papillary mucinous neoplasmsSeminars in Diagnostic Pathology, 2005
- Distinguishing Benign From Malignant Intraductal Papillary Mucinous Tumors of the Pancreas by Imaging TechniquesPancreas, 2004
- Intraductal Papillary Mucinous Neoplasms of the PancreasAnnals of Surgery, 2004
- Intraductal Papillary Mucinous Tumors of the Pancreas: Features With Multimodality ImagingJournal of Computer Assisted Tomography, 2002
- Pathology of Cancer of the PancreasSurgical Oncology Clinics of North America, 1998
- Histological Typing of Tumours of the Exocrine PancreasPublished by Springer Science and Business Media LLC ,1996
- Genetic alterations in the adenoma–carcinoma sequenceCancer, 1992