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Abstract：
Over the years, several guidelines have been introduced to guide management of mucinous pancreatic cystic neoplasms (mPCN). In this study, we aimed to evaluate and compare the clinically utility of the Sendai-06, Fukuoka-12, Fukuoka-17 and European-18 guidelines in predicting malignancy of mPCN.
One hundred and eighty-eight patients with mucinous cystic neoplasms (MCN) or intraductal papillary mucinous neoplasm (IPMN) who underwent surgery were retrospectively reviewed and classified under the 4 guidelines. Malignancy was defined as high grade dysplasia and invasive carcinoma.
Raised CA19-9>37U/ml, enhancing mural nodule≥5 mm and main pancreatic duct≥10 mm were significantly associated with malignancy on multivariate analysis. Increasing number of high risk features, absolute indications (European-18), worrisome risk or relative indications (European-18) were significantly associated with an increased likelihood of malignancy. The positive predictive values (PPV) of high risk features for Sendai-06, Fukuoka-12, Fukuoka-17 and absolute indications (European-18) for malignancy were 53%, 76%, 78% and 78% respectively. The negative predictive values (NPV) of the Sendai-06, Fukuoka-12 and Fukuoka-17 were 100%, while that of the European-18 was 92%. Risk of malignancy for patients with ≥4 worrisome features (Fukuoka-17) and ≥3 relative indications (European-18) was 66.7% and 75.0% respectively.
All 4 guidelines studied were useful in the initial triage of mPCN for the risk stratification of malignancy. The Fukuoka-17 had the highest PPV and NPV.
One hundred and eighty-eight patients with mucinous cystic neoplasms (MCN) or intraductal papillary mucinous neoplasm (IPMN) who underwent surgery were retrospectively reviewed and classified under the 4 guidelines. Malignancy was defined as high grade dysplasia and invasive carcinoma.
Raised CA19-9>37U/ml, enhancing mural nodule≥5 mm and main pancreatic duct≥10 mm were significantly associated with malignancy on multivariate analysis. Increasing number of high risk features, absolute indications (European-18), worrisome risk or relative indications (European-18) were significantly associated with an increased likelihood of malignancy. The positive predictive values (PPV) of high risk features for Sendai-06, Fukuoka-12, Fukuoka-17 and absolute indications (European-18) for malignancy were 53%, 76%, 78% and 78% respectively. The negative predictive values (NPV) of the Sendai-06, Fukuoka-12 and Fukuoka-17 were 100%, while that of the European-18 was 92%. Risk of malignancy for patients with ≥4 worrisome features (Fukuoka-17) and ≥3 relative indications (European-18) was 66.7% and 75.0% respectively.
All 4 guidelines studied were useful in the initial triage of mPCN for the risk stratification of malignancy. The Fukuoka-17 had the highest PPV and NPV.
摘要：
多年来,已经引入了一些指南来指导粘液性胰腺囊性肿瘤（mPCN）的治疗。在这项研究中,我们旨在评估和比较Sendai-06,Fukuoka-12,Fukuoka-17和European-18指南在预测mPCN恶性方面的临床实用性.
根据4种指南，回顾性回顾并分类了188例粘液性囊性肿瘤（MCN）或导管内乳头状粘液性肿瘤（IPMN）患者。恶性被定义为高度异型增生和浸润性癌。
升高的CA19-9>37U/ml，在多变量分析中,壁结节≥5mm和主胰管≥10mm与恶性肿瘤显著相关.越来越多的高风险特征，绝对适应症（欧洲-18），令人担忧的风险或相关适应症(European-18)与恶性肿瘤的可能性增加显著相关.Sendai-06，Fukuoka-12，Fukuoka-17的高风险特征的阳性预测值（PPV）和恶性肿瘤的绝对适应症（European-18）为53％，76%,分别为78%和78%。仙台-06、福冈-12和福冈-17的阴性预测值(NPV)为100%,而欧洲-18的比例为92%。具有≥4个令人担忧的特征（Fukuoka-17）和≥3个相对适应症（European-18）的患者的恶性肿瘤风险分别为66.7％和75.0％。
研究的所有4项指南均可用于mPCN的初始分类，以进行恶性肿瘤的风险分层。福冈-17的PPV和NPV最高。
根据4种指南，回顾性回顾并分类了188例粘液性囊性肿瘤（MCN）或导管内乳头状粘液性肿瘤（IPMN）患者。恶性被定义为高度异型增生和浸润性癌。
升高的CA19-9>37U/ml，在多变量分析中,壁结节≥5mm和主胰管≥10mm与恶性肿瘤显著相关.越来越多的高风险特征，绝对适应症（欧洲-18），令人担忧的风险或相关适应症(European-18)与恶性肿瘤的可能性增加显著相关.Sendai-06，Fukuoka-12，Fukuoka-17的高风险特征的阳性预测值（PPV）和恶性肿瘤的绝对适应症（European-18）为53％，76%,分别为78%和78%。仙台-06、福冈-12和福冈-17的阴性预测值(NPV)为100%,而欧洲-18的比例为92%。具有≥4个令人担忧的特征（Fukuoka-17）和≥3个相对适应症（European-18）的患者的恶性肿瘤风险分别为66.7％和75.0％。
研究的所有4项指南均可用于mPCN的初始分类，以进行恶性肿瘤的风险分层。福冈-17的PPV和NPV最高。
