Morphological Changes of Intraductal Papillary Mucinous Neoplasm of the Pancreas Are Not Enough for Indicators of the Development of Pancreatic Carcinoma During Follow Up

G A A b st ra ct s receiver operator characteristics curve. The factors associated with malignant IPMNs were determined by logistic regression analysis for BD-IPMN and MD-IPMN separately. Diagnostic accuracy of the determined predictors of malignancy was calculated. Results: Total 241 patients consisted of 202 BD-IPMN and 39 MD-IPMN were included. Cutoff values of cyst size, MPD diameter, and nodule size were determined for BD-IPMN as 30 mm, 6 mm, and 10 mm, respectively, whereas for MD-IPMN as 24 mm, 12 mm and 10 mm, respectively. For BD-IPMN, nodule size ≥10 mm (OR=176.97, p<0.0001) and positive cytology (OR127.14, p<0.0001) were significantly associated with malignant IPMN (Table 1). For MD-IPMN, nodule size ≥10 mm (OR=16.07, p=0.002) and positive cytology (OR=160.00, p<0.0001) were significantly associated with malignant IPMN. Sensitivity, specificity, and overall diagnostic accuracy of nodule size ≥10 mm alone were 59%, 98%, 90%, respectively, and positive cytology alone were 83%, 96%, 94%, respectively (Table 2). In combination of nodule size ≥10 mm and/or positive cytology, sensitivity, specificity, and overall diagnostic accuracy were 96%, 95%, and 95%, respectively. Conclusions: The common predictors, nodule size ≥10 mm and positive cytology, were demonstrated to be appropriate for both BD-IPMN and MD-IPMN. In combination of nodule size ≥10 mm and/or positive cytology as predictors of malignancy, diagnostic accuracy was shown to be excellent. Table 1. Factors associated with malignant IPMN determined by logistic regression analysis.