Malignant potential and specific characteristics of pure main duct type intraductal papillary mucinous neoplasm

被引：5

作者：

Fujita, Yoichi ^{[1
]}

Hirono, Seiko ^{[1
]}

Kawai, Manabu ^{[1
]}

Okada, Ken-ichi ^{[1
]}

Miyazawa, Motoki ^{[1
]}

Kitahata, Yuji ^{[1
]}

Ueno, Masaki ^{[1
]}

Hayami, Shinya ^{[1
]}

Kobayashi, Ryohei ^{[1
]}

Yanagisawa, Akio ^{[2
]}

Yamaue, Hiroki ^{[1
]}

机构：

[1] Wakayama Med Univ, Sch Med, Dept Surg 2, Wakayama, Japan

[2] Japanese Red Cross Kyoto Daiichi Hosp, Dept Pathol, Kyoto, Japan

来源：

EJSO | 2022年 / 48卷 / 05期

关键词：

IPMN; Main duct type; Malignant potential; Operative indication; Mural nodule height; CEA in Pancreatic juice; Category: original article; INTERNATIONAL CONSENSUS GUIDELINES; CARCINOEMBRYONIC ANTIGEN; ENDOSCOPIC-ULTRASOUND; RISK-FACTORS; PANCREAS; MANAGEMENT; IPMN; PROGRESSION; RESECTION; BENIGN;

D O I：

10.1016/j.ejso.2021.11.137

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: As the malignant potential of main duct (MD-) type intraductal papillary mucinous neoplasm (IPMN) has been discussed together with Mixed-type in most previous studies, the malignant potential of pure MD-type IPMN remains unclear. This study evaluated the specific characteristics and predictors of high-grade dysplasia (HGD) and invasive intraductal papillary mucinous carcinoma (IPMC) for pure MD-type IPMN. Methods: From 1,100 patients with IPMN, this study includes 387 patients that underwent surgery. We evaluated the specific characteristics of pure MD-type IPMN by comparing clinicopathological factors between MD-type (n = 79) and branch duct (BD-) type (n = 146) or Mixed-type IPMN (n = 162), and predictors of HGD/invasive IPMC in pure MD-type IPMN. Results: The rate of HGD/invasive IPMC was significantly higher in MD-type than in BD-type (70.9 vs. 48.6%, P = 0.001), although there was no difference between MD-type and Mixed-type IPMNs (P = 0.343). Recurrence-free survival (RFS) and disease-specific survival (DSS) of patients with MD-type were better than those of patients with Mixed-type (P = 0.008 and P = 0.009, respectively). There were no significant differences in RFS, overall survival, and DSS between patients with MD-type and patients with BD-type IPMNs. Multivariate analysis showed two independent predictors of HGD/invasive IPMC in MD-type IPMN; mural nodule height >= 5 mm (P = 0.025, odds ratio [OR]; 16.949) and carcinoembryonic antigen (CEA) level in the pancreatic juice obtained by preoperative endoscopic retrograde pancreatography >= 50 ng/ml (P = 0.039, OR; 9.091). Conclusions: Measurement of mural nodule height and CEA in the pancreatic juice might be useful in determining surgical indication for pure MD-type IPMN, although further studies for confirmation are essential. (C) 2021 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

引用

页码：1054 / 1061

页数：8

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