Fujino Yasuhiro, Matsumoto Ippei, Ueda Takashi, Toyama Hirotika, Kuroda Yoshikazu
Division of Gastroenterological Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Am J Surg. 2007 Sep;194(3):304-7. doi: 10.1016/j.amjsurg.2006.11.038.
Our objective was to predict malignancy for intraductal papillary mucinous neoplasms of the pancreas (IPMN) before operation.
Sixty-four resected patients with IPMN were examined and 17 parameters were investigated for their relation to malignancy by univariate and multivariate analysis.
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%.
This scoring system for IPMN is feasible to detect malignancy and useful for selecting an appropriate treatment.
我们的目的是在术前预测胰腺导管内乳头状黏液性肿瘤（IPMN）的恶性程度。
对64例接受手术切除的IPMN患者进行检查，并通过单因素和多因素分析研究17项参数与恶性程度的关系。
多因素逻辑回归分析显示，IPMN类型、主胰管大小和血清糖类抗原19-9对恶性程度具有显著意义。主胰管大小≥6.5 mm且血清糖类抗原19-9≥35 U/mL得3分，主胰管型得2分，乳头扩张、黄疸、糖尿病和肿瘤大小≥42 mm得1分。当使用新评分法对得3分及以上的IPMN诊断为恶性时，准确率为90.6%。
这种IPMN评分系统对于检测恶性程度是可行的，并且有助于选择合适的治疗方法。
