Bridging the intraductal papillary mucinous neoplasm risk stratification gap: A critical review of current and emerging biomarkers

Table 1 Clinical and morphological criteria defining features in intraductal papillary mucinous neoplasm management guidelines

	Clinic			Serology	Cytology	Morphology
	Jaundice	Acute pancreatitis	New-onset diabetes	CA19-9 (≥ 37 U/mL)	HGD/MLG	MPD > 10 mm	MPD 5-9.9 mm	Mural module > 5 mm	Mural module < 5 mm	Solid component	Cyst size	Wall enlargement	Lymphadenopathy	Growth rate
International evidence-based Kyoto guidelines	HRS	WF	WF	WF	HRS	HRS	WF	HRS	WF	HRS	WF (≥ 30 mm)	WF	WF	WF (≥ 2.5 mm/year)
European evidence-based guidelines	AI	RI	RI	RI	AI	AI	RI	AI	RI	AI	RI (≥ 40 mm)	NA	NA	RI (≥ 5 mm/year
AGA	NA	NA	NA	NA	CF	HRF (size not specified)		NA	NA	HRF	HRF (≥ 30 mm)	NA	NA	NA
ACG	HRC	HRC	NA	HRC	HRC	HRC	HRC	HRC	HRC	HRC	HRC (≥ 30 mm)	NA	NA	HRC (≥ 3 mm/year)

CA19-9: Carcinoembryonic antigen 19-9; HGD: High-grade dysplasia; MLG: Moderate-grade dysplasia; MPD: Main pancreatic duct; AGA: American Gastroenterological Association; ACG: American College of Gastroenterology; HRS: High-risk stigmata; AI: Absolute indication; NA: Not available; HRC: High-risk characteristic; WF: Worrisome feature; RI: Relative indication; CF: Concerning features; HRF: High-risk feature.