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KMID : 0191120110260060740
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Journal of Korean Medical Science
2011 Volume.26 No. 6 p.740 ~ p.746
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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
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Hwang Dae-Wook
Jang Jin-Young
Lim Chang-Sup
Lee Seung-Eun
Yoon Yoo-Seok
Ahn Young-Joon
Han Ho-Seong
Kim Sun-Whe
Kim Sang-Geol
Yun Young-Kook
Han Seong-Sik
Park Sang-Jae
Lim Tae-Jin
Kang Koo-Jung
Sim Mun-Sup
Choi Seong-Ho
Heo Jin-Seok
Choi Dong-Wook
Hur Kyung-Yul
Lee Dong-Shik
Yun Sung-Su
Kim Hong-Jin
Cho Chul-Kyoon
Kim Hyun-Jong
Yu Hee-Chul
Cho Baik-Hwan
Song In-Sang
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Abstract
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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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KEYWORD
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Branch Duct Type Intraductal Papillary Mucinous Neoplasm (IPMN), Cyst Size, Mural Nodule, CEA, Malignancy, Invasive Carcinoma
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