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Proposed new score predicting malignancy of intraductal papillary mucinous neoplasms of the pancreas.

Fujino Y, Matsumoto I, Ueda T, Toyama H, Kuroda Y

Division of Gastroenterological Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan. yasu120@med.kobe-u.ac.jp

BACKGROUND: Our objective was to predict malignancy for intraductal papillary mucinous neoplasms of the pancreas (IPMN) before operation. METHODS: Sixty-four resected patients with IPMN were examined and 17 parameters were investigated for their relation to malignancy by univariate and multivariate analysis. RESULTS: Multivariate logistic regression analysis showed that IPMN type, the size of main pancreatic duct, and serum carbohydrate antigen 19-9 were significant for malignancy. Size of the main pancreatic duct > or = 6.5 mm and serum carbohydrate antigen 19-9 > or = 35 U/mL scored 3 points, main duct type scored 2 points, and patulous papilla, jaundice, diabetes mellitus, and tumor size > or = 42 mm scored 1 point. When IPMNs with 3 and more than 3 points using the new score were diagnosed as malignant, accuracy was 90.6%. CONCLUSION: This scoring system for IPMN is feasible to detect malignancy and useful for selecting an appropriate treatment.

Published 13 August 2007 in Am J Surg, 194(3): 304-7.
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