Digestive diseases and sciences · 2017
Evaluation of the International Consensus Guidelines for the Surgical Resection of Intraductal Papillary Mucinous Neoplasms.
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Tsukagoshi Mariko, Araki Kenichiro, Saito Fumiyoshi, Kubo Norio, Watanabe Akira, Igarashi Takamichi, Ishii Norihiro, Yamanaka Takahiro, Shirabe Ken, Kuwano Hiroyuki
Аннотация
BACKGROUND: International consensus guidelines for intraductal papillary mucinous neoplasms (IPMNs) were revised in 2012.
AIMS: We aimed to evaluate the clinical utility of each predictor in the 2006 and 2012 guidelines and validate the diagnostic value and surgical indications.
METHODS: Forty-two patients with surgically resected IPMNs were included. Each predictor was applied to evaluate its diagnostic value.
RESULTS: The 2012 guidelines had greater accuracy for invasive carcinoma than the 2006 guidelines (64.3 vs. 31.0%). Moreover, the accuracy for high-grade dysplasia was also increased (48.6 vs. 77.1%). When the main pancreatic duct (MPD) size ≥8 mm was substituted for MPD size ≥10 mm in the 2012 guidelines, the accuracy for high-grade dysplasia was 80.0%.
CONCLUSIONS: The 2012 guidelines exhibited increased diagnostic accuracy for invasive IPMN. It is important to consider surgical resection prior to invasive carcinoma, and high-risk stigmata might be a useful diagnostic criterion. Furthermore, MPD size ≥8 mm may be predictive of high-grade dysplasia.
AIMS: We aimed to evaluate the clinical utility of each predictor in the 2006 and 2012 guidelines and validate the diagnostic value and surgical indications.
METHODS: Forty-two patients with surgically resected IPMNs were included. Each predictor was applied to evaluate its diagnostic value.
RESULTS: The 2012 guidelines had greater accuracy for invasive carcinoma than the 2006 guidelines (64.3 vs. 31.0%). Moreover, the accuracy for high-grade dysplasia was also increased (48.6 vs. 77.1%). When the main pancreatic duct (MPD) size ≥8 mm was substituted for MPD size ≥10 mm in the 2012 guidelines, the accuracy for high-grade dysplasia was 80.0%.
CONCLUSIONS: The 2012 guidelines exhibited increased diagnostic accuracy for invasive IPMN. It is important to consider surgical resection prior to invasive carcinoma, and high-risk stigmata might be a useful diagnostic criterion. Furthermore, MPD size ≥8 mm may be predictive of high-grade dysplasia.