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The carcinoembryonic antigen level in pancreatic juice and mural nodule size are predictors of malignancy for branch duct type intraductal papillary mucinous neoplasms of the pancreas.
Ann Surg. 2012 Mar; 255(3):517-22.AnnS

Abstract

OBJECTIVE

Identification of predictors of malignancy for branch duct type intraductal papillary mucinous neoplasms (IPMN).

BACKGROUND

Main duct type IPMN has been recommended for resection. However, the indications for resection of the branch duct type IPMN have been controversial.

METHODS

We retrospectively analyzed the clinicopathological factors of 134 patients undergoing resection for branch duct type IPMN, excluding main duct type IPMN, to identify predictors of the malignant behavior of this neoplasm. The cutoff values of tumor size, main pancreatic duct (MPD) size, mural nodule size, and carcinoembryonic antigen (CEA) level in the pancreatic juice obtained during preoperative endoscopic retrograde pancreatography (ERP) were analyzed using receiver-operator characteristic curves.

RESULTS

We found 7 significant predictors for malignancy in the branch duct type IPMN in a univariate analysis; jaundice, tumor occupying the pancreatic head, MPD size >5 mm, mural nodule size >5 mm, serum carbohydrate antigen (CA)19-9 level, positive cytology in the pancreatic juice, and CEA level in the pancreatic juice >30 ng/mL. In a multivariate analysis, a mural nodule size >5 mm and a CEA level in the pancreatic juice >30 ng/mL were independent factors associated with malignancy. The positive predictive value of a mural nodule size >5 mm and a CEA level in the pancreatic juice >30 ng/mL was 100%, and the negative predictive value was 96.3%.

CONCLUSIONS

We identified 2 useful predictive factors for malignancy in branch duct type IPMN; a mural nodule size >5 mm and a CEA level in the pancreatic juice obtained by preoperative ERP >30 ng/mL.

Authors+Show Affiliations

Second Department of Surgery, Wakayama Medical University, School of Medicine, Kimiidera, Wakayama, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22301608

Citation

Hirono, Seiko, et al. "The Carcinoembryonic Antigen Level in Pancreatic Juice and Mural Nodule Size Are Predictors of Malignancy for Branch Duct Type Intraductal Papillary Mucinous Neoplasms of the Pancreas." Annals of Surgery, vol. 255, no. 3, 2012, pp. 517-22.
Hirono S, Tani M, Kawai M, et al. The carcinoembryonic antigen level in pancreatic juice and mural nodule size are predictors of malignancy for branch duct type intraductal papillary mucinous neoplasms of the pancreas. Ann Surg. 2012;255(3):517-22.
Hirono, S., Tani, M., Kawai, M., Okada, K., Miyazawa, M., Shimizu, A., Kitahata, Y., & Yamaue, H. (2012). The carcinoembryonic antigen level in pancreatic juice and mural nodule size are predictors of malignancy for branch duct type intraductal papillary mucinous neoplasms of the pancreas. Annals of Surgery, 255(3), 517-22. https://doi.org/10.1097/SLA.0b013e3182444231
Hirono S, et al. The Carcinoembryonic Antigen Level in Pancreatic Juice and Mural Nodule Size Are Predictors of Malignancy for Branch Duct Type Intraductal Papillary Mucinous Neoplasms of the Pancreas. Ann Surg. 2012;255(3):517-22. PubMed PMID: 22301608.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The carcinoembryonic antigen level in pancreatic juice and mural nodule size are predictors of malignancy for branch duct type intraductal papillary mucinous neoplasms of the pancreas. AU - Hirono,Seiko, AU - Tani,Masaji, AU - Kawai,Manabu, AU - Okada,Ken-ichi, AU - Miyazawa,Motoki, AU - Shimizu,Atsushi, AU - Kitahata,Yuji, AU - Yamaue,Hiroki, PY - 2012/2/4/entrez PY - 2012/2/4/pubmed PY - 2012/3/28/medline SP - 517 EP - 22 JF - Annals of surgery JO - Ann Surg VL - 255 IS - 3 N2 - OBJECTIVE: Identification of predictors of malignancy for branch duct type intraductal papillary mucinous neoplasms (IPMN). BACKGROUND: Main duct type IPMN has been recommended for resection. However, the indications for resection of the branch duct type IPMN have been controversial. METHODS: We retrospectively analyzed the clinicopathological factors of 134 patients undergoing resection for branch duct type IPMN, excluding main duct type IPMN, to identify predictors of the malignant behavior of this neoplasm. The cutoff values of tumor size, main pancreatic duct (MPD) size, mural nodule size, and carcinoembryonic antigen (CEA) level in the pancreatic juice obtained during preoperative endoscopic retrograde pancreatography (ERP) were analyzed using receiver-operator characteristic curves. RESULTS: We found 7 significant predictors for malignancy in the branch duct type IPMN in a univariate analysis; jaundice, tumor occupying the pancreatic head, MPD size >5 mm, mural nodule size >5 mm, serum carbohydrate antigen (CA)19-9 level, positive cytology in the pancreatic juice, and CEA level in the pancreatic juice >30 ng/mL. In a multivariate analysis, a mural nodule size >5 mm and a CEA level in the pancreatic juice >30 ng/mL were independent factors associated with malignancy. The positive predictive value of a mural nodule size >5 mm and a CEA level in the pancreatic juice >30 ng/mL was 100%, and the negative predictive value was 96.3%. CONCLUSIONS: We identified 2 useful predictive factors for malignancy in branch duct type IPMN; a mural nodule size >5 mm and a CEA level in the pancreatic juice obtained by preoperative ERP >30 ng/mL. SN - 1528-1140 UR - https://www.unboundmedicine.com/medline/citation/22301608/The_carcinoembryonic_antigen_level_in_pancreatic_juice_and_mural_nodule_size_are_predictors_of_malignancy_for_branch_duct_type_intraductal_papillary_mucinous_neoplasms_of_the_pancreas_ L2 - https://Insights.ovid.com/pubmed?pmid=22301608 DB - PRIME DP - Unbound Medicine ER -