title: Determination of malignant and invasive predictors in branch duct type intraductal papillary mucinous neoplasms of the pancreas: a suggested scoring formula.
abstract: Prediction of malignancy or invasiveness of branch duct type intraductal papillary mucinous neoplasm (Br-IPMN) is difficult, and proper treatment strategy has not been well established. The authors investigated the characteristics of Br-IPMN and explored its malignancy or invasiveness predicting factors to suggest a scoring formula for predicting pathologic results. From 1994 to 2008, 237 patients who were diagnosed as Br-IPMN at 11 tertiary referral centers in Korea were retrospectively reviewed. The patients' mean age was 63.1 ± 9.2 yr. One hundred ninty-eight (83.5%) patients had nonmalignant IPMN (81 adenoma, 117 borderline atypia), and 39 (16.5%) had malignant IPMN (13 carcinoma in situ, 26 invasive carcinoma). Cyst size and mural nodule were malignancy determining factors by multivariate analysis. Elevated CEA, cyst size and mural nodule were factors determining invasiveness by multivariate analysis. Using the regression coefficient for significant predictors on multivariate analysis, we constructed a malignancy-predicting scoring formula: 22.4 (mural nodule [0 or 1]) + 0.5 (cyst size [mm]). In invasive IPMN, the formula was expressed as invasiveness-predicting score = 36.6 (mural nodule [0 or 1]) + 32.2 (elevated serum CEA [0 or 1]) + 0.6 (cyst size [mm]). Here we present a scoring formula for prediction of malignancy or invasiveness of Br-IPMN which can be used to determine a proper treatment strategy.
authors.affiliation: Department of Surgery, and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Dae Wook
authors.initials: DW
authors.lastname: Hwang
authors.forename: Jin-Young
authors.initials: JY
authors.lastname: Jang
authors.forename: Chang-Sup
authors.initials: CS
authors.lastname: Lim
authors.forename: Seung Eun
authors.initials: SE
authors.lastname: Lee
authors.forename: Yoo-Seok
authors.initials: YS
authors.lastname: Yoon
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Ahn
authors.forename: Ho-Seong
authors.initials: HS
authors.lastname: Han
authors.forename: Sun-Whe
authors.initials: SW
authors.lastname: Kim
authors.forename: Sang Geol
authors.initials: SG
authors.lastname: Kim
authors.forename: Young Kook
authors.initials: YK
authors.lastname: Yun
authors.forename: Seong-Sik
authors.initials: SS
authors.lastname: Han
authors.forename: Sang-Jae
authors.initials: SJ
authors.lastname: Park
authors.forename: Tae Jin
authors.initials: TJ
authors.lastname: Lim
authors.forename: Koo Jung
authors.initials: KJ
authors.lastname: Kang
authors.forename: Mun Sup
authors.initials: MS
authors.lastname: Sim
authors.forename: Seong Ho
authors.initials: SH
authors.lastname: Choi
authors.forename: Jin Seok
authors.initials: JS
authors.lastname: Heo
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Choi
authors.forename: Kyung Yul
authors.initials: KY
authors.lastname: Hur
authors.forename: Dong-Shik
authors.initials: DS
authors.lastname: Lee
authors.forename: Sung-Su
authors.initials: SS
authors.lastname: Yun
authors.forename: Hong-Jin
authors.initials: HJ
authors.lastname: Kim
authors.forename: Chul Kyoon
authors.initials: CK
authors.lastname: Cho
authors.forename: Hyun Jong
authors.initials: HJ
authors.lastname: Kim
authors.forename: Hee Chul
authors.initials: HC
authors.lastname: Yu
authors.forename: Baik Hwan
authors.initials: BH
authors.lastname: Cho
authors.forename: In-Sang
authors.initials: IS
authors.lastname: Song
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002272:Carcinoembryonic Antigen / Q000097:blood; D021441:Carcinoma, Pancreatic Ductal / Q000473:pathology*; D002291:Carcinoma, Papillary / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000473:pathology*; D011237:Predictive Value of Tests; D012372:ROC Curve; D014057:Tomography, X-Ray Computed
chemical_list: D002272:Carcinoembryonic Antigen