title: Predictors of malignant intraductal papillary mucinous neoplasm of the pancreas.
abstract: OBJECTIVE
  The predictors of malignant intraductal papillary mucinous neoplasm (IPMN) and invasive IPMN were investigated in this study to determine the optimal indicators of surgical resection for IPMN.
  
  
  BACKGROUND
  Recently, international consensus guidelines have described the standard indicators of resection for IPMN. However, the indicators of surgical resection for IPMN, especially for branch duct IPMN, still remain controversial.
  
  
  METHODS
  Eighty-two patients with IPMN who underwent surgical resection during April 1998 to January 2009, were retrospectively reviewed and examined with regard to their preoperative factors and pathologic diagnosis.
  
  
  RESULTS
  Multivariate analysis showed that main duct IPMN (P<0.01) and earlier diabetes (P=0.03) were independent predictors of malignant IPMN. In branch duct IPMN, the diameter of the main pancreatic duct (MPD) was found to be significantly associated with malignancy by univariate analysis (P=0.034). An elevated serum CA19-9 level (P<0.01) was an independent predictor of invasive IPMN.
  
  
  CONCLUSIONS
  Our observations suggest that main duct IPMN, branch duct IPMN with MPD dilatation, and IPMN with an elevated serum CA19-9 level should be considered as indications for surgical resection.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Mimura
authors.forename: Atsuhiro
authors.initials: A
authors.lastname: Masuda
authors.forename: Ippei
authors.initials: I
authors.lastname: Matsumoto
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Shiomi
authors.forename: Shiei
authors.initials: S
authors.lastname: Yoshida
authors.forename: Maki
authors.initials: M
authors.lastname: Sugimoto
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Sanuki
authors.forename: Masaru
authors.initials: M
authors.lastname: Yoshida
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Fujita
authors.forename: Hiromu
authors.initials: H
authors.lastname: Kutsumi
authors.forename: Yonsou
authors.initials: Y
authors.lastname: Ku
authors.forename: Takeshi
authors.initials: T
authors.lastname: Azuma
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D018395:CA-19-9 Antigen / Q000097:blood; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D002291:Carcinoma, Papillary / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D032921:Consensus; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010180:Pancreatectomy / Q000379:methods; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies
chemical_list: D018395:CA-19-9 Antigen