Watanabe Yusuke, Niina Yusuke, Nishihara Kazuyoshi, Okayama Takafumi, Tamiya Sadafumi, Nakano Toru
a Departments of Surgery , Kitakyushu Municipal Medical Center , Kitakyushu , Japan.
b Department of Gastroenterology , Kitakyushu Municipal Medical Center , Kitakyushu , Japan.
Acta Chir Belg. 2018 Aug;118(4):239-245. doi: 10.1080/00015458.2018.1427329. Epub 2018 Jan 15.
Accurate preoperative prediction for malignant IPMN is still challenging. The aim of this study was to investigate the validity of neutrophil-to-lymphocyte ratio (NLR) and mural nodule height (MNH) for predicting malignant intraductal papillary mucinous neoplasm (IPMN).
The medical records of 60 patients who underwent pancreatectomy for IPMN were retrospectively reviewed.
NLR tended to be higher in malignant IPMN (median: 2.23) than in benign IPMN (median: 2.04; p = .14). MNH was significantly greater in malignant IPMN (median: 16 mm) than in benign IPMN (median: 8 mm; p < .01). The optimal cutoff values for the NLR and MNH were 3.60 and 11 mm, respectively. The sensitivity and specificity of NLR ≥3.60 for predicting malignant IPMN were 40% and 93%, and those of MNH ≥11 mm were 73% and 77%, respectively. Univariate analysis revealed that NLR ≥3.60 (p < .01) and MNH ≥11 mm (p < .01) were significant predictive factors. On multivariate analysis, enhanced solid component was identified as an independent factor, but NLR ≥3.60 and MNH ≥11 mm were not.
NLR and MNH are suboptimal tests in predicting malignant IPMN; however, they can be useful to assist in clinical decision-making.
对恶性胰管内乳头状黏液性肿瘤（IPMN）进行准确的术前预测仍具有挑战性。本研究旨在探讨中性粒细胞与淋巴细胞比值（NLR）和壁结节高度（MNH）对预测恶性胰管内乳头状黏液性肿瘤（IPMN）的有效性。
回顾性分析60例行IPMN胰腺切除术患者的病历。
恶性IPMN患者的NLR（中位数：2.23）往往高于良性IPMN患者（中位数：2.04；p = 0.14）。恶性IPMN患者的MNH（中位数：16mm）显著大于良性IPMN患者（中位数：8mm；p < 0.01）。NLR和MNH的最佳临界值分别为3.60和11mm。NLR≥3.60预测恶性IPMN的敏感性和特异性分别为40%和93%，MNH≥11mm的敏感性和特异性分别为73%和77%。单因素分析显示，NLR≥3.60（p < 0.01）和MNH≥11mm（p < 0.01）是显著的预测因素。多因素分析显示，实性成分增强是独立因素，但NLR≥3.60和MNH≥11mm不是。
NLR和MNH在预测恶性IPMN方面并非最佳检测指标；然而，它们有助于临床决策。
