HPB : the official journal of the International Hepato Pancreato Biliary Association · 2026
Risk prediction model for high-grade dysplasia in resected pancreatic mucinous cystic neoplasms: a nomogram-based approach.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Aguilera Munoz Lina, Laurent Lucie, Salmeron Sandra, Lorenzo Diane, Sauvanet Alain, Paye François, Svrcek Magali, Navez Julie, Michoud Claire, Saurin Jean-Christophe, Périnel Julie, Adham Mustapha, Branche Julien, Schwarz Lilian, Chaigneau Thomas, Dupont Benoit, Tribillon Ecoline, de Ponthaud Charles, Gaujoux Sébastien, Napoléon Bertrand, d'Engremont Christelle, Deregnaucourt Teddy, Foubert Fanny, Le Rhun Marc, Ronot Maxime, Nicolle Rémy, Ernst Olivier, Cros Jérôme, Vullierme Marie-Pierre, Rebours Vinciane
Аннотация
BACKGROUND: Mucinous cystic neoplasms (MCN) are precancerous pancreatic lesions. Their management is challenged by the lack of robust predictors of malignancy. This study aimed to identify preoperative predictors of high-grade dysplasia (HGD) or invasive carcinoma and to develop a predictive nomogram.
METHODS: This multicenter retrospective study included patients who underwent resection for MCN between 2008 and 2021 across 13 centers. Surgical decisions were based on European guideline criteria. Diagnosis required ovarian-type stroma. Preoperative CT/MRI were centrally reviewed by an expert radiologist blinded to pathology. Independent predictors of ≥HGD were identified using multivariable logistic regression.
RESULTS: Among 198 patients, 32 (16 %) had ≥ HGD, including 14 (7 %) with invasive carcinoma. Independent predictors were older age (median 52.5 vs 45 years, p = 0.01), symptomatic presentation (72% vs 47%, OR 2.88, p = 0.01), larger cyst size (85 vs 46.5 mm, p < 0.001), and mural nodules (56% vs 15 %, OR 7.25, p < 0.001). The nomogram achieved an accuracy of 0.89 and an AUC of 0.86; a 10% risk threshold provided 85 % sensitivity. An interactive web-based calculator is publicly available.
CONCLUSION: Age, symptoms, cyst size, and mural nodules independently predict malignancy in resected MCNs. A validated nomogram and online calculator may support individualized surgical versus surveillance strategies.
METHODS: This multicenter retrospective study included patients who underwent resection for MCN between 2008 and 2021 across 13 centers. Surgical decisions were based on European guideline criteria. Diagnosis required ovarian-type stroma. Preoperative CT/MRI were centrally reviewed by an expert radiologist blinded to pathology. Independent predictors of ≥HGD were identified using multivariable logistic regression.
RESULTS: Among 198 patients, 32 (16 %) had ≥ HGD, including 14 (7 %) with invasive carcinoma. Independent predictors were older age (median 52.5 vs 45 years, p = 0.01), symptomatic presentation (72% vs 47%, OR 2.88, p = 0.01), larger cyst size (85 vs 46.5 mm, p < 0.001), and mural nodules (56% vs 15 %, OR 7.25, p < 0.001). The nomogram achieved an accuracy of 0.89 and an AUC of 0.86; a 10% risk threshold provided 85 % sensitivity. An interactive web-based calculator is publicly available.
CONCLUSION: Age, symptoms, cyst size, and mural nodules independently predict malignancy in resected MCNs. A validated nomogram and online calculator may support individualized surgical versus surveillance strategies.
Предметные рубрики MeSH
HumansNomogramsFemaleRetrospective StudiesMiddle AgedPancreatic NeoplasmsRisk AssessmentMaleRisk FactorsAdultPredictive Value of TestsPancreatectomyAgedNeoplasm GradingNeoplasms, Cystic, Mucinous, and SerousTomography, X-Ray ComputedMagnetic Resonance ImagingPrecancerous ConditionsDecision Support Techniques