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Determination of malignant and invasive predictors in branch duct type intraductal papillary mucinous neoplasms of the pancreas : a suggested scoring formula / Dae Wook Hwang ; Jin-Young Jang ; Chang-Sup Lim ; Seung Eun Lee ; Yoo-Seok Yoon ; Young Joon Ahn ; Ho-Seong Han ; Sun-Whe Kim ; Sang Geol Kim ; Young Kook Yun ; Seong-Sik Han ; Sang-Jae Park ; Tae Jin Lim ; Koo Jung Kang ; Mun Sup Sim ; Seong Ho Choi ; Jin Seok Heo ; Dong Wook Choi ; Kyung Yul Hur ; Dong-Shik Lee ; Sung-Su Yun ; Hong-Jin Kim ; Chul Kyoon Cho ; Hyun Jong Kim ; Hee Chul Yu ; Baik Hwan Cho ; In-Sang Song 1

[요약] 1

Introduction 1

Materials and methods 2

Selection of enrolled centers and radiologic parameters 2

Study population and clinicopathological characteristics 2

Statistical analysis 3

Ethics statement 4

Results 4

Malignancy-predicting factors 4

Invasiveness-predicting factors 4

Scoring formula for malignancy and invasiveness 4

Malignancy-predicting scores 4

Invasiveness-predicting scores 5

Discussion 5

References 6

Author summary 7

초록보기

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.

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참고문헌 (24건) : 자료제공( 네이버학술정보 )

참고문헌 목록에 대한 테이블로 번호, 참고문헌, 국회도서관 소장유무로 구성되어 있습니다.
번호 참고문헌 국회도서관 소장유무
1 Intraductal Papillary Mucinous Neoplasm of the Pancreas 네이버 미소장
2 Histopathological Diagnosis of Pancreatic Intraepithelial Neoplasia and Intraductal Papillary-Mucinous Neoplasms: Interobserver Agreement 네이버 미소장
3 International consensus guidelines for management of intraductal papillary mucinous neoplasms and mucinous cystic neoplasms of the pancreas. 네이버 미소장
4 Jang JY, Kim SW, Lee SE, Yang SH, Lee KU, Lee YJ, Kim SC, Han DJ, Choi DW, Choi SH, Heo JS, Cho BH, Yu HC, Yoon DS, Lee WJ, Lee HE, Kang GH, Lee JM. Treatment guidelines for branch duct type intraductal papillary mucinous neoplasms of the pancreas: when can we operate or observe? Ann Surg Oncol 2008; 15: 199-205. 미소장
5 Intraductal papillary mucinous neoplasms: predictors of malignant and invasive pathology. 네이버 미소장
6 Main-duct intraductal papillary mucinous neoplasms of the pancreas: clinical predictors of malignancy and long-term survival following resection. 네이버 미소장
7 Jang JY, Kim SW, Ahn YJ, Yoon YS, Choi MG, Lee KU, Han JK, Kim WH, Lee YJ, Kim SC, Han DJ, Kim YI, Choi SH, Cho BH, Yu HC, Yoon DS, Lee WJ, Lee KB, Kim YC, Lee KS, Kim MW, Kim HJ, Park YH. Multicenter analysis of clinicopathologic features of intraductal papillary mucinous tumor of the pancreas: is it possible to predict the malignancy before surgery? Ann Surg Oncol 2005; 12: 124-32. 미소장
8 Paik KY, Choi SH. Experience of limited pancreatic head resection for management of branch duct intraductal papillary mucinous neoplasm in a single center. World J Gastroenterol 2009; 15: 2904-7. 미소장
9 Clinicopathologic analysis of surgically proven intraductal papillary mucinous neoplasms of the pancreas in SNUH: a 15-year experience at a single academic institution. 네이버 미소장
10 CT vs MRCP: optimal classification of IPMN type and extent. 네이버 미소장
11 Intraductal papillary mucinous neoplasm of pancreas: multi-detector row CT with 2D curved reformations--correlation with MRCP. 네이버 미소장
12 Intraductal papillary mucinous tumour of the pancreas: differentiation of malignancy and benignancy by CT 네이버 미소장
13 Moons KG, Harrell FE, Steyerberg EW. Should scoring rules be based on odds ratios or regression coefficients? J Clin Epidemiol 2002; 55: 1054-5. 미소장
14 Ohashi K, Murakami Y, Murayama M, Taketoshi T, Ohta T, Ohashi I. Four cases of mucin-producing cancer of the pancreas on specific findings of the papilla of Vater. Prog Dig Endosc 1982; 20: 348-51. 미소장
15 Intraductal papillary-mucinous tumors of the pancreas: Differential diagnosis between benign and malignant tumors by endoscopic ultrasonography 네이버 미소장
16 MDCT of Intraductal Papillary Mucinous Neoplasm of the Pancreas: Evaluation of Features Predictive of Invasive Carcinoma 네이버 미소장
17 Clinicopathological features and medical management of intraductal papillary mucinous neoplasms 네이버 미소장
18 Preoperative predictors of malignancy in pancreatic intraductal papillary mucinous neoplasms. 네이버 미소장
19 Inferior branch–preserving superior head resection of the pancreas with gastric wall–covering method for intraductal papillary mucinous adenoma 네이버 미소장
20 The Prognosis of Intraductal Papillary Mucinous Tumors of the Pancreas 네이버 미소장
21 Intraductal papillary-mucinous tumors of the pancreas: predictive criteria of malignancy according to pathological examination of 53 cases. 네이버 미소장
22 Branch-duct intraductal papillary mucinous neoplasms of the pancreas: to operate or not to operate? 네이버 미소장
23 Predictive factors for malignancy in intraductal papillary–mucinous tumours of the pancreas 네이버 미소장
24 Management of intraductal papillary-mucinous neoplasm of the pancreas: treatment strategy based on morphologic classification. 네이버 미소장

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