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Main pancreatic duct involved IPMN without high-risk factors: how to judge the degree of malignancy based on MPD dilation?
- Source :
-
Medicine [Medicine (Baltimore)] 2024 Aug 16; Vol. 103 (33), pp. e39323. - Publication Year :
- 2024
-
Abstract
- The aim of this study was to evaluate the cutoff value for identifying malignance in main pancreatic duct (MPD)-involved intraductal papillary mucinous neoplasm (IPMN) with an MPD diameter ranging from 5 to 10 mm. Clinical-radiological characteristics of 142 patients, including MPD-involved IPMNs (n = 53) and branch-duct (BD)-IPMNs (n = 89) were analyzed. Logistic regression analysis was used to determine the risk factors of malignant IPMNs and invasive carcinoma. ROC curves were used to identify different cutoffs in terms of preoperative MPD values to predict the presence of invasive carcinoma as well as malignant IPMNs, and the prediction performance was evaluated. For MPD-involved IPMNs (5 mm < MPD < 10 mm), MPD diameter of 7.5 mm for discriminating malignant IPMNs (area under curve [AUC] = 0.67) and 7.7 mm for discriminating invasive IPMNs (AUC = 0.56) were found to be the optimal cutoff values at receiver operating characteristic curve (ROC) analysis. MPD > 7.5 mm and carbohydrate antigen19-9 (Ca19-9) > 37 U/ml were found to be predictors of malignant IPMNs at univariate, and MPD > 7.5 mm was a predictor in multivariate analysis in MPD-involved IPMNs. The AUC of the ROC curve of MPD (7.5 mm) combined with Ca19-9 in identifying malignant IPMNs was 0.73 in MPD-involved IPMNs. MPD (7.5 mm) combined with Ca19-9 performed well in identifying malignant IPMNs in MPD-involved IPMNs.<br />Competing Interests: The authors have no conflicts of interest to disclose.<br /> (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)
- Subjects :
- Humans
Male
Female
Middle Aged
Aged
Risk Factors
ROC Curve
Retrospective Studies
CA-19-9 Antigen blood
Adult
Adenocarcinoma, Mucinous pathology
Aged, 80 and over
Pancreatic Ducts pathology
Pancreatic Ducts diagnostic imaging
Pancreatic Neoplasms pathology
Pancreatic Neoplasms diagnosis
Pancreatic Intraductal Neoplasms pathology
Carcinoma, Pancreatic Ductal pathology
Carcinoma, Pancreatic Ductal diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1536-5964
- Volume :
- 103
- Issue :
- 33
- Database :
- MEDLINE
- Journal :
- Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 39151506
- Full Text :
- https://doi.org/10.1097/MD.0000000000039323