Shimura Tatsuo, Kofunato Yasuhide, Okada Ryo, Yashima Rei, Okada Koji, Araki Kenichiro, Hosouchi Yasuo, Kuwano Hiroyuki, Takenoshita Seiichi
Department of Cancer Biology and Electronics, Fukushima Medical University, Fukushima 960-1295, Japan.
Department of Organ Regulatory Surgery, Fukushima Medical University, Fukushima 960-1295, Japan.
Mol Clin Oncol. 2016 Aug;5(2):317-322. doi: 10.3892/mco.2016.908. Epub 2016 May 20.
Despite strict criteria for the observation of intraductal papillary mucinous neoplasm (IPMN), it remains difficult to distinguish invasive IPMN from non-invasive IPMN. The aim of the present study was to identify an indicator of invasive IPMN. The present study retrospectively evaluated 53 patients (28 with non-invasive and 25 with invasive IPMN) who underwent resection of IPMN, and examined the usefulness of the MIB-1 labeling index as an indicator of invasive IPMN. The MIB-1 labeling indexes in patients with invasive IPMN were significantly higher compared with those with non-invasive IPMN (P<0.001). A receiver operating characteristic curve revealed that the area under the curve was 0.822. These results suggested that a cut-off level for the MIB-1 labeling index should be set to 15.5% to distinguish invasive from non-invasive IPMN. A multivariate analysis using a logistic regression model revealed the MIB-1 labeling index (hazard ratio, 18.692; 95% confidential interval, 4.171-83.760; P<0.001) and the existence of mural nodules (hazard ratio, 6.187, 95% confidential interval, 1.039-36.861; P=0.045) were predictive factors for invasive IPMN. However, no statistically significant differences were observed between patients with a lower MIB-1 labeling index and patients with a higher MIB-1 labeling index (P=0.798). The MIB-1 labeling index must be considered as a candidate for the classification of IPMN.
尽管对于导管内乳头状黏液性肿瘤（IPMN）的观察有严格标准，但区分浸润性IPMN和非浸润性IPMN仍然困难。本研究的目的是确定浸润性IPMN的一个指标。本研究回顾性评估了53例行IPMN切除术的患者（28例非浸润性IPMN和25例浸润性IPMN），并检验了MIB-1标记指数作为浸润性IPMN指标的有效性。浸润性IPMN患者的MIB-1标记指数显著高于非浸润性IPMN患者（P<0.001）。受试者工作特征曲线显示曲线下面积为0.822。这些结果表明，应将MIB-1标记指数的临界值设定为15.5%，以区分浸润性和非浸润性IPMN。使用逻辑回归模型进行的多变量分析显示，MIB-1标记指数（风险比，18.692；95%置信区间，4.171 - 83.760；P<0.001）和壁结节的存在（风险比，6.187，95%置信区间，1.039 - 36.861；P = 0.045）是浸润性IPMN的预测因素。然而，MIB-1标记指数较低的患者和MIB-1标记指数较高的患者之间未观察到统计学上的显著差异（P = 0.798）。MIB-1标记指数必须被视为IPMN分类的一个候选指标。
