Takao Ohtsuka1, Masafumi Nakamura1, Susumu Hijioka2, Yasuhiro Shimizu3, Michiaki Unno4, Minoru Tanabe5, Yuichi Nagakawa6, Kyoichi Takaori7, Seiko Hirono8, Naoto Gotohda9, Wataru Kimura10, Kei Ito11, Akio Katanuma12, Tsuyoshi Sano13, Takahiro Urata14, Emiri Kita15, Keiji Hanada16, Minoru Tada17, Takeshi Aoki18, Masahiro Serikawa19, Kojun Okamoto20, Hiroyuki Isayama21, Yoshitaka Gotoh1, Kousei Ishigami22, Hiroshi Yamaguchi23, Kenji Yamao24, Masanori Sugiyama25, Kazuichi Okazaki26,27. 1. From the Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka. 2. Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo. 3. Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya. 4. Department of Surgery, Tohoku University Graduate School of Medicine, Sendai. 5. Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University. 6. Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo. 7. Department of Surgery, Kyoto University, Kyoto. 8. Second Department of Surgery, School of Medicine, Wakayama Medical University, Wakayama. 9. Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital East, Kashiwa, Chiba. 10. Department of Gastroenterological, General, Breast and Thyroid Surgery, Faculty of Medicine, Yamagata University, Yamagata. 11. Department of Gastroenterology, Sendai City Medical Center, Sendai. 12. Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo. 13. Department of Surgery, Division of Gastroenterological Surgery, Aichi Medical University, Nagakute. 14. Department of Gastroenterology, Japanese Red Cross Kumamoto Hospital, Kumamoto. 15. Department of Gastroenterology, Chiba Cancer Center, Chiba. 16. Department of Gastroenterology, Onomichi General Hospital, Onomichi, Japan. 17. Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo. 18. Department of Gastroenterological and General Surgery, School of Medicine, Showa University, Tokyo. 19. Department of Gastroenterology and Metabolism, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima. 20. Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, Hidaka. 21. Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo. 22. Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nishihara, Okinawa. 23. Department of Pathology, Tokyo Medical University, Tokyo. 24. Department of Gastroenterology, Narita Memorial Hospital, Nagoya. 25. Department of Surgery, Kyorin University School of Medicine, Mitaka, Tokyo. 26. The Third Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kansai Medical University, Osaka. 27. Japan Pancreas Society, Hirakara, Osaka, Japan.
Abstract
OBJECTIVE: The aim of the study was to develop a formula for predicting the probability of malignancy of mucinous cystic neoplasm (MCN) of the pancreas with ovarian-type stroma. METHODS: A total of 364 patients were enrolled. A total score was calculated as the sum of the approximate integers of the odds ratios of the predictive factors identified by multivariate analysis. The relationship between the total score and pathological results was assessed. RESULTS: A total of 321 patients had benign MCN and 43 had malignant MCN. Five possible predictive factors were analyzed: 56 years or older, high serum carcinoembryonic antigen level, high carbohydrate antigen 19-9 level, tumor size of 51 mm or greater, and the presence of mural nodules. The total score was significantly higher in patients with malignant MCN (median, 24; range, 0-37) compared with benign MCN (median, 5; range, 0-33; P < 0.001). Receiver operating characteristic curve analysis demonstrated that the area under the curve was 0.86, and the sensitivity and specificity of the total score for discriminating malignant MCNs were 72% and 83%, respectively, using a cut-off value of 22. CONCLUSIONS: The current simple formula can predict the malignancy of MCN and may thus contribute to the adequate management of patients with MCN.
OBJECTIVE: The aim of the study was to develop a formula for predicting the probability of malignancy of mucinous cystic neoplasm (MCN) of the pancreas with ovarian-type stroma. METHODS: A total of 364 patients were enrolled. A total score was calculated as the sum of the approximate integers of the odds ratios of the predictive factors identified by multivariate analysis. The relationship between the total score and pathological results was assessed. RESULTS: A total of 321 patients had benign MCN and 43 had malignant MCN. Five possible predictive factors were analyzed: 56 years or older, high serum carcinoembryonic antigen level, high carbohydrate antigen 19-9 level, tumor size of 51 mm or greater, and the presence of mural nodules. The total score was significantly higher in patients with malignant MCN (median, 24; range, 0-37) compared with benign MCN (median, 5; range, 0-33; P < 0.001). Receiver operating characteristic curve analysis demonstrated that the area under the curve was 0.86, and the sensitivity and specificity of the total score for discriminating malignant MCNs were 72% and 83%, respectively, using a cut-off value of 22. CONCLUSIONS: The current simple formula can predict the malignancy of MCN and may thus contribute to the adequate management of patients with MCN.
Authors: Jose M Ramia; Juan Del Rio Martín; Gerardo Blanco-Fernández; Miguel Cantalejo-Diaz; Fernando Pardo; Elena Muñoz-Forner; Alberto Carabias; Alba Manuel-Vazquez; Pedro J Hernández-Rivera; Isabel Jaén-Torrejimeno; Helga K Kälviäinen-Mejia; Fernando Rotellar-Sastre; Marina Garcés-Albir; Raquel Latorre; Texell Longoria-Dubocq; Noelia De Armas-Conde; Alejandro Serrablo-Requejo; Sara Esteban Gordillo; Luis Sabater; Mario Serradilla-Martín Journal: Gland Surg Date: 2022-05