Low HDL-Cholesterol is Associated with Malignant Intraductal Papillary Mucinous Neoplasms: A Multicenter Study

Abstract

Background: Intraductal papillary mucinous neoplasms (IPMNs) has the potential of malignant transformation. Previous studies showed that HDL-c was related to risk of cancer. In this study, we showed the association between HDL-c and the incidence of malignancy in IPMNs.Material and methods: 226 patients with histologically proven IPMNs who underwent surgery were included in the present study. 151 patients were assigned to training group andother 75 patients was set as a validation. Patients’ demographic information, clinical data, and pathological features were obtained from medical records. Those with high grade dysplasia and invasive carcinoma were defined as malignant IPMNs. Logistic regression analyses were used to show the association between HDL-cand malignant IPMNs. Receiver operating characteristic (ROC) curves were performed to show the predictive performance. Results: Prevalence of low HDL-c in patients with malignant IPMNs was higher than those with non-malignant IPMNs (p < 0.01) both in training group and validation group. Prevalence of malignant IPMNs was decreased with the increase of HDL-c both in all IPMNs and Branch-Duct IPMNs (BD-IPMNs).Logistic analysis showed that low HDL-c was associated with malignant IPMNs (OR =20.56, 95% CI:2.58 - 163.64) in all IPMNs and BD-IPMNs (OR = 17.6, 95%CI: 1.16-268.46).The predictive performance of mural nodule plus low HDL-c was higher than that of mural nodule alone or mural nodule plus cyst size in identifying malignant BD-IPMNs.Conclusion: HDL-c may be a potential biomarker for identifying malignant IPMNs. Moreover, HDL-c may improve the predictive ability of malignancy in BD-IPMNs.