Okamura Yukiyasu, Sano Shusei, Sugiura Teiichi, Ito Takaaki, Yamamoto Yusuke, Ashida Ryo, Ishiwatari Hirotoshi, Matsubayashi Hiroyuki, Sasaki Keiko, Uesaka Katsuhiko
Pancreas. 2018 Mar;47(3):285-290. doi: 10.1097/MPA.0000000000001001.
The aim of the present study was to validate the use of the 2012 International Consensus Guidelines for intraductal papillary mucinous neoplasm (IPMN) (Fukuoka criteria) in patients without findings of obstructive jaundice and/or an enhanced solid component.
This retrospective study included patients who underwent pancreatectomy for IPMN between October 2002 and September 2016. The sensitivity, specificity, and positive and negative predictive values for malignancy were calculated for each feature of high-risk stigmata.
Of the 135 patients who underwent surgery for IPMN, 50 (37.0%) had low/intermediate-grade dysplasia, 25 (18.5%) had high-grade dysplasia, and the remaining 60 (44.5%) had invasive carcinoma. A malignant potential was, thus, present in 63% of all resected cases. Considering an actual clinical situation, the predictors for malignant potential were assessed in 62 patients without findings of obstructive jaundice and/or an enhanced solid component. A multivariate analysis revealed that the Fukuoka criteria were the only independent factor for predicting the malignant potential (odds ratio, 5.69; P = 0.036).
The present study suggested that malignant potential can be accurately detected by faithfully keeping to the Fukuoka criteria. Using these criteria enables us to identify patients with malignant potential, even in the actual clinical situations.
本研究旨在验证2012年国际导管内乳头状黏液性肿瘤（IPMN）共识指南（福冈标准）在无梗阻性黄疸和/或强化实性成分表现的患者中的应用。
这项回顾性研究纳入了2002年10月至2016年9月期间因IPMN接受胰腺切除术的患者。计算了高危征象各特征对恶性肿瘤的敏感性、特异性、阳性和阴性预测值。
在135例因IPMN接受手术的患者中，50例（37.0%）为低/中级发育异常，25例（18.5%）为高级别发育异常，其余60例（44.5%）为浸润性癌。因此，在所有切除病例中，63%存在恶性潜能。考虑到实际临床情况，对62例无梗阻性黄疸和/或强化实性成分表现的患者评估了恶性潜能的预测因素。多因素分析显示，福冈标准是预测恶性潜能的唯一独立因素（比值比，5.69；P = 0.036）。
本研究表明，严格遵循福冈标准可准确检测恶性潜能。使用这些标准使我们能够在实际临床情况下识别具有恶性潜能的患者。
