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Predictors of Malignancy in “Pure” Branch-Duct Intraductal Papillary Mucinous Neoplasm of the Pancreas without Enhancing Mural Nodules on CT Imaging: A Nationwide Multicenter Study

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Author(s)
Tae-Hyeon KimYoung-Sik WooHyung-Ku ChonJin-Hyeok HwangKyo-Sang YooWoo-Jin LeeKwang-Hyuck LeeJong-Kyun LeeSeok-Ho DongChang-Hwan ParkEun-Taek ParkJong-Ho MoonHo-Gak KimKwang-Bum ChoHong-Ja KimSeung-Ok LeeYoung-Koog CheonJeong-Mi LeeJin-Woo ParkMyung-Hwan Kim
Keimyung Author(s)
Cho, Kwang Bum
Department
Dept. of Internal Medicine (내과학)
Journal Title
Gut and Liver
Issued Date
2018
Volume
12
Issue
5
Keyword
Branch duct-IPMNNeoplasmsMulticenter studyMural nodule
Abstract
Background/Aims:
Presence of enhanced mural nodules, which can be visualized using computed tomography (CT), is one of high-risk stigmata in branch-duct intraductal papillary mucinous neoplasms (BD-IPMNs). Conversely, the absence of enhanced mural nodules on preoperative imaging does not exclude malignant risk. The present study aimed to investigate other morphological features as predictors of malignancy in “pure” BD-IPMNs without enhanced mural nodules on CT.

Methods:
This retrospective study included 180 patients with surgically confirmed “pure” BD-IPMNs of the pancreas and no enhanced mural nodules on preoperative CT. The study was conducted at 15 tertiary referral centers throughout South Korea. Univariate and multivariate analyses were used to identify significant predictors of malignancy.

Results:
BD-IPMNs with low-grade (n=84) or moderate-grade (n=76) dysplasia were classified as benign; those with highgrade dysplasia (n=8) or invasive carcinoma (n=12) were classified as malignant. The multivariate analysis revealed that cyst size ≥30 mm (odds ratio, 8.6; p=0.001) and main pancreatic duct diameter ≥5 mm (odds ratio, 4.1; p=0.01) were independent risk factors for malignancy in “pure” BDIPMNs without enhanced mural nodules on CT. Endoscopic ultrasound detected enhanced mural nodules (6/82) that had been missed on CT, and two IPMNs with enhanced mural nodules were malignant.

Conclusions:
In patients with “pure” BD-IPMNs who have no enhanced mural nodules on CT, cyst size ≥30 mm and main pancreatic duct diameter ≥5 mm may be associated with malignancy.
Keimyung Author(s)(Kor)
조광범
Publisher
School of Medicine (의과대학)
Citation
Tae-Hyeon Kim et al. (2018). Predictors of Malignancy in “Pure” Branch-Duct Intraductal Papillary Mucinous Neoplasm of the Pancreas without Enhancing Mural Nodules on CT Imaging: A Nationwide Multicenter Study. Gut and Liver, 12(5), 583–590. doi: 10.5009/gnl17582
Type
Article
ISSN
2005-1212
Source
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6143451/
DOI
10.5009/gnl17582
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/41712
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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