Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan road, 210008, Nanjing, China.
Department of Radiology, the Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong road, 210029, Nanjing, China.
Lipids Health Dis. 2021 Aug 28;20(1):94. doi: 10.1186/s12944-021-01523-8.
Intraductal papillary mucinous neoplasms (IPMNs) can potentially undergo malignant transformation. Studies have shown that high-density lipoprotein cholesterol (HDL-c) was associated with the risk of cancer. In this study, the association between HDL-c and the incidence of malignancy in IPMNs was investigated.
226 patients with histologically proven IPMNs who underwent surgery were included in the present study. Patients were assigned to a training group (n = 151) and validation group (n = 75). Patients' demographic information, clinical data, and histopathological evaluation findings were obtained from medical records. Malignant IPMNs were defined as lesions that showed high grade dysplasia and invasive carcinoma. Logistic regression analyses were used to show the association between HDL-c and malignant IPMNs. Receiver operating characteristic (ROC) curves were generated to analyze predictive performance.
The prevalence of low HDL-c levels was higher in patients with malignant IPMNs than in those with non-malignant IPMNs (P < 0.01) in both the training group and validation group. The prevalence of malignant IPMNs decreased with an increase in HDL-c levels both in patients with all types of IPMNs, as well as in those with branch-duct IPMNs (BD-IPMNs).Logistic analysis showed that low HDL-c levels were associated with malignant IPMNs (odds ratio (OR) = 20.56, 95 % confidence interval (CI): 2.58-163.64, P < 0.01) in all types of IPMNs and BD-IPMNs (OR = 17.6, 95 %CI: 1.16-268.46, P = 0.02 ).The predictive performance of mural nodules plus low HDL-c levels was higher than that of mural nodules alone or mural nodules plus cyst size for the identification of malignant BD-IPMNs.
HDL-c levels may serve a potential biomarker for identifying malignant IPMNs and improve the predictive ability of malignancy in BD-IPMNs.
导管内乳头状黏液性肿瘤（IPMN）可能发生恶性转化。研究表明，高密度脂蛋白胆固醇（HDL-c）与癌症风险相关。本研究旨在探讨 HDL-c 与 IPMN 恶性程度之间的关系。
本研究纳入了 226 例经组织学证实的 IPMN 患者，所有患者均接受了手术治疗。患者被分为训练组（n=151）和验证组（n=75）。研究人员从病历中获取了患者的人口统计学信息、临床数据和组织病理学评估结果。恶性 IPMN 定义为高分级异型增生和浸润性癌。采用逻辑回归分析显示 HDL-c 与恶性 IPMN 之间的关系。绘制受试者工作特征（ROC）曲线以分析预测性能。
在训练组和验证组中，恶性 IPMN 患者的低 HDL-c 水平发生率均高于非恶性 IPMN 患者（P<0.01）。在所有类型的 IPMN 患者以及分支胰管型 IPMN（BD-IPMN）患者中，随着 HDL-c 水平的升高，恶性 IPMN 的发生率均降低。逻辑分析显示，低 HDL-c 水平与所有类型的 IPMN 和 BD-IPMN 中的恶性 IPMN 相关（OR=20.56，95%CI：2.58-163.64，P<0.01）。壁结节加低 HDL-c 水平对恶性 BD-IPMN 的预测性能高于壁结节或壁结节加囊肿大小。
HDL-c 水平可能是一种潜在的生物标志物，有助于识别恶性 IPMN，并提高对 BD-IPMN 恶性程度的预测能力。
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