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Pancreatology. 2018 Jun;18(4):399-406. doi: 10.1016/j.pan.2018.04.005. Epub 2018 Apr 13.

Multifocal cysts and incidence of pancreatic cancer concomitant with intraductal papillary mucinous neoplasm.

Author information

1
Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan.
2
Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan. Electronic address: atmasuda@med.kobe-u.ac.jp.
3
Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Japan.
4
Division of Diagnostic Pathology, Kobe University Graduate School of Medicine, Japan.
5
Department of Radiology, Kobe University Graduate School of Medicine, Japan.
6
Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan; Department of Gastroenterology and Hepatology, Kinki University Hospital, Faculty of Medicine, Japan.
7
Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan; Department of Gastroenterology, Nissay Hospital, Japan.
8
Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan; Department of Gastroenterology, Kakogawa Central City Hospital, Japan.
9
Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan; Center for Clinical Research and Advanced Medicine Establishment, Shiga University of Medical Science, Japan.

Abstract

OBJECTIVES:

The present study was conducted in order to elucidate the relationship between the number of cyst-existing regions and incidence of pancreatic ductal adenocarcinoma (PDAC) concomitant with intraductal papillary mucinous neoplasm (IPMN), which currently remains unclear.

METHODS:

Subjects comprised 141 patients undergoing resection for IPMN (Non-invasive IPMN (IPMN with low-to high-grade dysplasia): N = 94, invasive IPMN: N = 31, and PDAC concomitant with IPMN: N = 16) between November 2000 and February 2017. A logistic regression analysis was performed to assess the relationship between the number of cyst-existing regions (one region/two or more regions) and incidence of PDAC concomitant with IPMN, adjusted by clinical characteristics. Cyst-existing regions were defined by the number of anatomical parts of the pancreas: the head/body/tail of the pancreas.

RESULTS:

Multiple cyst-existing regions (two or more regions) correlated with the incidence of PDAC concomitant with IPMN (PDAC concomitant with IPMN in one region vs. two or more regions: 3/66 vs. 13/75, multivariable odds ratio [OR] = 4.11, 95% confidence interval [CI] = 1.22 to 18.8, P = 0.02). In contrast, multiple cyst-existing regions did not correlate with the incidence of IPMN (invasive IPMN in one region vs. two or more regions: 13/66 vs. 18/75, OR = 1.19, 95% CI = 0.52 to 2.76, P = 0.67).

CONCLUSIONS:

Multifocal cysts correlated with the incidence of PDAC concomitant with IPMN, and may be a high-risk factor for PDAC concomitant with IPMN.

KEYWORDS:

Intraductal papillary mucinous neoplasm; Number of cyst-existing regions; Pancreatic cancer

PMID:
29685673
DOI:
10.1016/j.pan.2018.04.005
[Indexed for MEDLINE]

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