title: Preoperative evaluation of malignancy in intraductal papillary mucinous neoplasms of the pancreas, especially in relation to dysplastic epithelial changes.
abstract: OBJECTIVE
  Intraductal papillary mucinous neoplasms have a better prognosis than ductal adenocarcinomas of the pancreas. The aim of this study was to evaluate the malignant potential of IPMNs by their preoperative images.
  
  
  METHODS
  Forty-three intraductal papillary mucinous neoplasms were divided into 3 duct ectatic types using preoperative images (the main duct type, the branch duct type, and the mixed type), and into 2 groups using resected specimens (the malignant group including severe dysplasia based on the WHO classification and the benign group). The diameters of the tumor, main pancreatic duct and mural nodule were measured on the images.
  
  
  RESULTS
  Two thirds of main duct type cases were in the malignant group. For the branch duct and mixed types, the diameters of the tumor and detectable mural nodules were larger in the malignant group than in the benign group. A tumor diameter larger than 3.5cm and a mural nodule diameter larger than 6mm were risk factors for malignancy (p < 0.05).
  
  
  CONCLUSIONS
  The main duct type, a tumor larger than 3.5cm of the branch duct or mixed type, and a mural nodule larger than 6mm were all indicators of malignancy risk.
authors.affiliation: Department of Abdominal Surgery, Tenri Hospital, Nara, Japan. masakis@river.ocn.ne.jp
authors.forename: Masaki
authors.initials: M
authors.lastname: Mizumoto
authors.forename: Gen
authors.initials: G
authors.lastname: Honjo
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Kobashi
authors.forename: Satoru
authors.initials: S
authors.lastname: Nishimura
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Tsunehiro
authors.initials: T
authors.lastname: Yoshimura
authors.forename: Masayuki
authors.initials: M
authors.lastname: Awane
authors.forename: Yasuro
authors.initials: Y
authors.lastname: Kato
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Furuyama
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Asao
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Maeda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takakuwa
authors.forename: Satoru
authors.initials: S
authors.lastname: Matsusue
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000473:pathology* / Q000601:surgery; D002291:Carcinoma, Papillary / Q000473:pathology* / Q000601:surgery; D006801:Humans; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery; D011300:Preoperative Care