Preoperative predictors of malignancy and invasive carcinoma in intraductal papillary mucinous neoplasms

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Author:
WANG Lei(Department of Gastroenterology,Changhai Hospital,The Second Military Medical University,Shanghai 200433,China)
JIN Gang(Department of Gastroenterology,Changhai Hospital,The Second Military Medical University,Shanghai 200433,China)
WANG Li(Department of Gastroenterology,Changhai Hospital,The Second Military Medical University,Shanghai 200433,China)
ZHENG Jian-ming(Department of Gastroenterology,Changhai Hospital,The Second Military Medical University,Shanghai 200433,China)
JIN Zhen-dong(Department of Gastroenterology,Changhai Hospital,The Second Military Medical University,Shanghai 200433,China)
ZOU Duo-wu(Department of Gastroenterology,Changhai Hospital,The Second Military Medical University,Shanghai 200433,China)
ZHANG Hua-gao(Department of Gastroenterology,Changhai Hospital,The Second Military Medical University,Shanghai 200433,China)
CAI Quan-cai(Department of Gastroenterology,Changhai Hospital,The Second Military Medical University,Shanghai 200433,China)
LI Zhao-shen(Department of Gastroenterology,Changhai Hospital,The Second Military Medical University,Shanghai 200433,China)
Journal Title:
CHINESE JOURNAL OF PANCREATOLOGY
Issue:
Volume 10, Issue 05, 2010
DOI:
10.3760/cma.j.issn.1674-1935.2010.05.006
Key Word:
Pancreatic neoplasms;Intraductal papillary mucinous neoplasm;Diagnosis;Therapy;Survive rate

Abstract´╝Ü Objective To investigate the predictive factors for malignancy and invasive carcinoma of IPMN, and the survival rates of different pathological type of IPMN were compared. Methods Seventy-eight patients with IPMN admitted to Changhai Hospital from January 1993 to September 2009, who underwent surgery with histological evidence were retrospectively analyzed. The univariate and multivariate analysis of potential predictive factors, including medical history, clinical presentations, liver function, CEA, CA19-9,and imaging findings was conducted to identify the predictive factors for malignancy and invasive carcinoma of IPMN. Results Univariate analysis identified jaundice, acute pancreatitis history, CA19-9 Level > 37U/ml,AKP, unclear border of tumour as independent predictive factors for malignancy and invesiveness, main pancreatic duct dilation, branch pancreatic duct diameter > 30 mm, presence of mural modules were identified as malignancy predictor. CEA > 6 ng/ml was identified as invasive carcinoma predictor. Multivariate analysis identified one independent predictive factor for malignancy or invasive carcinoma: unclear border of tumour.Another factor of invasive IPMN was acute pancreatitis. The 5 year survival rate for benign 1PMN was 100%,while 2 year survival rate for malignant IPMN was 78.9%, 5 year survival rate was 68.5%. The 2 year survival rate for invasive IPMN was 64.6%, 5 year survival rate was 43.1%. Conclusions Unclear border of tumour was predictive factors for malignancy; acute pancreatitis and unclear border of tumour were predictive factors for invasive carcinoma.

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