Brief Article
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World J Gastroenterol. Nov 14, 2010; 16(42): 5353-5358
Published online Nov 14, 2010. doi: 10.3748/wjg.v16.i42.5353
Predictive factors associated with malignancy of intraductal papillary mucinous pancreatic neoplasms
Jin Hee Lee, Kyu Taek Lee, Jongwook Park, Sun Youn Bae, Kwang Hyuck Lee, Jong Kyun Lee, Kee-Taek Jang, Jin Seok Heo, Seong Ho Choi, Dong Wook Choi, Jong Chul Rhee
Jin Hee Lee, Kyu Taek Lee, Jongwook Park, Sun Youn Bae, Kwang Hyuck Lee, Jong Kyun Lee, Jong Chul Rhee, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135710, South Korea
Kee-Taek Jang, Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135710, South Korea
Jin Seok Heo, Seong Ho Choi, Dong Wook Choi, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135710, South Korea
Author contributions: Lee JH wrote the paper; Lee KT designed the study; Park J, Bae SY, Lee KH and Lee JK review the manuscript for important intellectual content; Jang KT made the pathological diagnoses; Heo JS, Choi SH and Choi DW provided study objects and analytical tool; Rhee JC supervised this study.
Correspondence to: Kyu Taek Lee, MD, PhD, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135710, South Korea. happymap@skku.edu
Telephone: +82-2-34103409 Fax: +82-2-34106983
Received: June 28, 2010
Revised: July 21, 2010
Accepted: July 28, 2010
Published online: November 14, 2010
Abstract

AIM: To identify preoperative predictive factors associated with malignancy of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas.

METHODS: Between April 1995 and April 2010, 129 patients underwent surgical resection for IPMNs at our institute and had confirmed pathologic diagnoses. The medical records were retrospectively reviewed and immunohistochemical staining for mucin (MUC) in pancreatic tissues was performed.

RESULTS: Univariate analysis showed that the following five variables were closely associated with malignant IPMNs preoperatively: absence of extrapancreatic malignancy; symptoms; tumor size > 4 cm; main pancreatic duct (MPD) size > 7 mm; and lymph node enlargement on preoperative computed tomography (CT). Multivariate analysis revealed that the following two factors were significantly associated with malignant IPMNs preoperatively: MPD size > 7 mm [odds ratio (OR) = 2.50]; and lymph node enlargement on preoperative CT (OR = 3.57). No significant differences in the expression of MUC1, MUC2 and MUC5AC were observed between benign and malignant IPMNs.

CONCLUSION: MPD size > 7 mm and preoperative lymph node enlargement on CT are useful predictive factors associated with malignancy of IPMNs.

Keywords: Intraductal papillary mucinous neoplasms; Malignancy; Predictive factors; Pancreatic neoplasms