Proposed new score predicting malignancy of intraductal papillary mucinous neoplasms of the pancreas

Fujino, Yasuhiro; Matsumoto, Ippei; Ueda, Takashi; Toyama, Hirotika; Kuroda, Yoshikazu

doi:10.1016/j.amjsurg.2006.11.038

Cited by 23 publications

(17 citation statements)

References 15 publications

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“…Of these studies, 33 investigated mural nodules5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 21 examined dilatation of the main pancreatic duct (MPD)7 9, 15 16, 18 21, 23 26, 27 30, 32 36, 38, 39, 40, 41, 42, 43, 44, 45, 46, 21 analysed cyst size5 7, 8, 9 14, 15 18, 20 23, 25 27, 28 31, 36 38, 40 41, 43 47, 48, 49, 17 assessed CA19‐9 increase14 …”

Section: Resultsmentioning

confidence: 99%

Predictive performance of factors associated with malignancy in intraductal papillary mucinous neoplasia of the pancreas

et al. 2018

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BackgroundEstimation of the risk of malignancy in intraductal papillary mucinous neoplasia (IPMN) of the pancreas is a clinical challenge. Several routinely used clinical factors form the basis of the current consensus guidelines. This study aimed to determine the predictive values of the most commonly assessed risk factors.MethodsA meta‐analysis of individual risk factors of malignancy in IPMN was performed. Contingency tables were derived from these data, and sensitivity, specificity, negative and positive predictive values, and diagnostic odds ratios (DOR) were determined. Hierarchical summary receiver operating characteristic (HSROC) curves for each factor were calculated and the respective area under the curve (AUC) was assessed.ResultsA total of 3443 studies were screened initially. Analysis of recent literature revealed 60 studies with 13 relevant risk factors including clinical, serological and radiological parameters. The largest area under the HSROC curve was found for weight loss (0·84) and jaundice/raised bilirubin level (0·80), followed by increased carcinoembryonic antigen (CEA) (0·79) or carbohydrate antigen (CA) 19‐9 (0·78) levels. The most sensitive factors were patient age (71 per cent) and mural nodules (65 per cent), and jaundice/raised bilirubin level (97 per cent) and increased CEA level (95 per cent) were most specific. None of the analysed factors reached a positive or negative level of prediction beyond 90 per cent.ConclusionNone of the established criteria safely distinguishes malignant from non‐malignant lesions.

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Section: Resultsmentioning

confidence: 99%

Predictive performance of factors associated with malignancy in intraductal papillary mucinous neoplasia of the pancreas

et al. 2018

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“…However, recent studies showed that resection of branch duct IPMNs that had a cyst of more than 30 mm resulted in oversurgery in many cases [6][7][8][9][10]. Although a mural nodule is a predictor of malignancy in branch duct IPMN [6,7,[11][12][13][14][15][16], nodule size has hardly been taken into consideration, with the exception of a few studies which found that branch duct IPMNs with mural nodules of more than 5 mm included not a few benign neoplasms [17][18][19]. In the present study, we followed up branch duct IPMNs without mural nodules and those with mural nodules of less than 9 mm until nodules developed or enlarged to a size of 10 mm, and we investigated whether the size of 10 mm was appropriate as an indicator of surgery for branch duct IPMN.…”

Section: Introductionmentioning

confidence: 97%

Size of mural nodule as an indicator of surgery for branch duct intraductal papillary mucinous neoplasm of the pancreas during follow-up

et al. 2010

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“…CA19-9 is also a validated tumor marker in clinical use for pancreatic cancer [18]. In contrast, gender, localization, mural nodules, abdominal pain, other tumors, a history of pancreatitis, age, cyst size, serum carcinoembryonic antigen (CEA) and serum amylase do not function as reliable significant markers, which is shown by Fujino et al [14]. Compared to serum CEA (threshold of 5 ng/ml), serum CA19-9 is a better predictor of malignancy [17].…”

Section: Symptoms and Diagnosismentioning

confidence: 95%

“…Main duct (MD) IPMNs mostly cause symptoms, whereas branch duct (BD) IPMNs are often asymptomatic [9]. It is necessary to predict the malignancy of IPMNs before treatment because of the different potentials of developing into a carcinoma in situ [14]. Therefore, it is important to find risk factors and markers.…”

Section: Symptoms and Diagnosismentioning

confidence: 99%

“…Patulous papilla, jaundice, diabetes mellitus, tumor size, the size of the main pancreatic duct and the serum level of carbohydrate antigen 19-9 (CA19-9, with a threshold of 35 ng/ml) serve as important markers for the characterization of a malignant IPMN [14,17]. CA19-9 is also a validated tumor marker in clinical use for pancreatic cancer [18].…”

Section: Symptoms and Diagnosismentioning

confidence: 99%

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Molecular Characterization and Pathogenesis of Intraductal Papillary Mucinous Neoplasms of the Pancreas

Benzel

Fendrich²

2015

Eur Surg Res

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Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas are noninvasive neoplasms which occur in the main pancreatic duct or its major branches. IPMNs have an important meaning in the clinic and in research since they represent around 20% of all resected pancreatic neoplasms. Morphologically, branch duct, main duct and mixed-type IPMNs can be distinguished. Histologically, they can be divided into gastric, intestinal, pancreatobiliary and oncocytic type. There are different mutations in genes such as KRAS, GNAS, RNF43 and p53. The expression of miRNAs is specific to IPMNs; altogether, 14 miRNAs have been identified so far which are differently expressed in all IPMNs in contrast to normal pancreatic tissue. It has also been observed that methylation levels can be altered in IPMNs. This review summarizes the molecular characteristics of IPMNs of the pancreas and presents currently known markers.

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Proposed new score predicting malignancy of intraductal papillary mucinous neoplasms of the pancreas

Cited by 23 publications

References 15 publications

Predictive performance of factors associated with malignancy in intraductal papillary mucinous neoplasia of the pancreas

Predictive performance of factors associated with malignancy in intraductal papillary mucinous neoplasia of the pancreas

Size of mural nodule as an indicator of surgery for branch duct intraductal papillary mucinous neoplasm of the pancreas during follow-up

Molecular Characterization and Pathogenesis of Intraductal Papillary Mucinous Neoplasms of the Pancreas

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