title: Validation of a nomogram for predicting the probability of carcinoma in patients with intraductal papillary mucinous neoplasm in 180 pancreatic resection patients at 3 high-volume centers.
abstract: OBJECTIVE
  We previously published a nomogram for prediction of carcinoma in patients with intraductal papillary mucinous neoplasm (IPMN). The objective of the current study was to validate this nomogram in an external cohort of patients at multiple institutions.
  
  
  METHODS
  The clinical details of 180 patients with IPMN who underwent a pancreatic resection at 3 hospitals were collected. Four significant predictive factors (sex, lesion type, nodule height, and pancreatic juice cytology) were analyzed.
  
  
  RESULTS
  Of the 180 patients, 66 (36.7%) had a main pancreatic duct-type IPMN and 114 (63.3%) had a branch pancreatic duct-type IPMN. The final pathological diagnosis was benign IPMN in 95 (52.8%) patients and malignant IPMN in 85 (47.2%) patients. The area under the receiver operating characteristic curve for the model was 0.760. The area under the receiver operating characteristic curve of the IPMN nomogram for prediction of malignancy was 0.747 in main pancreatic duct-type IPMN and 0.752 in branch pancreatic duct-type IPMN. The sensitivity and specificity of the model were 80.0% and 57.9%, respectively, when the predictive probability of more than 10% was used to indicate the presence of carcinoma.
  
  
  CONCLUSIONS
  This nomogram for predicting the probability of carcinoma in patients with IPMN was accurate in an external validation patient cohort.
authors.affiliation: From the *Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya; †Second Department of Surgery, School of Medicine, Wakayama Medical University, Wakayama; ‡Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo; §Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya; ∥Division of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan; ¶Department of Medical Hepatology, Institute of Liver and Biliary Sciences, Delhi, India; and #Department of Pathology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shimizu
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yamaue
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Maguchi
authors.forename: Kenji
authors.initials: K
authors.lastname: Yamao
authors.forename: Seiko
authors.initials: S
authors.lastname: Hirono
authors.forename: Manabu
authors.initials: M
authors.lastname: Osanai
authors.forename: Susumu
authors.initials: S
authors.lastname: Hijioka
authors.forename: Yukihide
authors.initials: Y
authors.lastname: Kanemitsu
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Sano
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Senda
authors.forename: Vikram
authors.initials: V
authors.lastname: Bhatia
authors.forename: Akio
authors.initials: A
authors.lastname: Yanagisawa
mesh_terms: D000368:Aged; D019540:Area Under Curve; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis* / Q000601:surgery; D002291:Carcinoma, Papillary / Q000175:diagnosis* / Q000601:surgery; D003661:Decision Support Techniques; D019160:Endosonography; D005260:Female; D061847:Hospitals, High-Volume; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D018297:Neoplasms, Cystic, Mucinous, and Serous / Q000175:diagnosis* / Q000601:surgery; D049451:Nomograms; D010180:Pancreatectomy; D010189:Pancreatic Juice / Q000166:cytology; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000601:surgery; D011237:Predictive Value of Tests; D011336:Probability; D012372:ROC Curve; D015203:Reproducibility of Results; D012737:Sex Factors; D014057:Tomography, X-Ray Computed