Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center Hospital, 1007, Shimo-Nagakubo, Sunto-Nagaizumi, Shizuoka, 411-8777, Japan.
Division of Diagnostic Pathology, Shizuoka Cancer Center Hospital, Shizuoka, Japan.
Sci Rep. 2021 Jan 12;11(1):568. doi: 10.1038/s41598-020-79583-6.
The preoperative accurate diagnosis is difficult in the patients with intraductal papillary mucinous neoplasm (IPMN). The aim of the present study was to elucidate the roles of systemic inflammation responses and nutritional status indexes in IPMN. High-grade dysplasia was classified as a malignant neoplasm in the study. We retrospectively reviewed 155 patients who underwent pancreatectomy. The correlation between the clinical factors and several indexes of a systemic inflammation response and nutritional status was analyzed. Among the biomarkers, prognostic nutritional index (PNI) value of malignant IPMN patients was significantly lower than that of benign IPMN patients (P = 0.023), whereas PNI was not significant predictor for malignant IPMN. The multivariate analysis showed that a PNI < 43.5 (odds ratio [OR] 16.1, 95% CI 1.88-138.5, P = 0.011) and a carbohydrate antigen (CA) 19-9 level > 22.5 U/mL (OR 6.64, 95% CI 1.73-25.6, P = 0.006) were significant independent predictors of the presence of lymph node metastasis (LNM). Our scoring system developed based on these two factors. Patients with a score of 0 had no LNM and zero disease-related death. The present study suggested the roles of PNI on the IPMN patients who undergo curative pancreatectomy.
术前对导管内乳头状黏液性肿瘤（IPMN）患者的准确诊断较为困难。本研究旨在阐明全身炎症反应和营养状况指标在 IPMN 中的作用。高级别异型增生在本研究中被归类为恶性肿瘤。我们回顾性分析了 155 例行胰腺切除术的患者。分析了临床因素与全身炎症反应和营养状况的几个指标之间的相关性。在这些生物标志物中，恶性 IPMN 患者的预后营养指数（PNI）值明显低于良性 IPMN 患者（P=0.023），但 PNI 并不是恶性 IPMN 的显著预测因子。多因素分析显示，PNI<43.5（比值比 [OR] 16.1，95%可信区间 1.88-138.5，P=0.011）和 CA19-9 水平>22.5 U/mL（OR 6.64，95%可信区间 1.73-25.6，P=0.006）是淋巴结转移（LNM）存在的独立显著预测因子。我们基于这两个因素开发了评分系统。评分 0 的患者无 LNM 且无疾病相关死亡。本研究提示 PNI 在接受根治性胰腺切除术的 IPMN 患者中的作用。
