alexa Acute Pancreatitis is a Predictive Factor for Malignancy in Mixed or Main Duct Intraductal Papillary Mucinous Neoplasms | OMICS International | Abstract
ISSN: 2165-7092

Pancreatic Disorders & Therapy
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Research Article

Acute Pancreatitis is a Predictive Factor for Malignancy in Mixed or Main Duct Intraductal Papillary Mucinous Neoplasms

Wataru Kimura* and Koji Tezuka
First Department of Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
Corresponding Author : Wataru Kimura
First Department of Surgery
Department of Gastroenterological
Breast, Thyroid and General Surgery
Yamagata University Faculty of Medicine
2-2-2 Iida-Nishi, Yamagata 990-9585, Japan
Tel: +81-023-628-5336
Fax: +81-023-628-5339
E-mail: [email protected]
Received November 24, 2014; Accepted February 16, 2015; Published February 18, 2015
Citation: Kimura W, Tezuka K (2015) Acute Pancreatitis is a Predictive Factor for Malignancy in Mixed or Main Duct Intraductal Papillary Mucinous Neoplasms. Pancreat Disord Ther 5:148. doi:10.4172/2165-7092.1000148
Copyright: © 2015 Kimura W, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Objectives: It is still unclear whether acute pancreatitis (AP) is a predictor of malignancy. Using patients enrolled
from a single institution, the objective of this study was to determine whether AP as a complication of intraductal
papillary mucinous neoplasm (IPMN) predicts malignancy, and to clarify the clinicopathological characteristics of
IPMN with AP.
Methods: The clinicopathological features of 87 patients who underwent surgical resection for IPMN between
October 1998 and May 2010 were investigated. In this study, malignancy was defined as high-grade dysplasia (noninvasive
carcinoma) and invasive carcinoma. Macroscopic classification was based on the 2012 international
consensus guidelines and IPMN with a main pancreatic duct size of >5 mm was classified as either mixed or main
duct IPMN.
Results: Among the patients, who underwent surgical resection for IPMN, AP was present in 18% (16/87) and
malignancy was present in 43% (37/87). The median period from the first AP episode until surgery was 5.5 months
(range: 1.0-116.3 months). There was no significant difference in the frequency of malignancy between IPMN
patients with and without AP [63% (10/16) vs. 38% (27/71); p=0.096]. In mixed or main duct IPMN, malignancy was
more frequent in patients with AP than in those without AP [91% (10/11) vs. 48% (22/46); P=0.016]. Comparison of
the clinicopathological features between malignant IPMN with and without AP showed that the frequency of highgrade
dysplasia (non-invasive carcinoma) was significantly higher in the former [80% (8/10) vs. 37% (10/27);
P=0.029].
Conclusions: AP itself may not be a predictive factor for malignancy in IPMN, but may be such a predictor in
mixed or main duct IPMN. AP is also an important clinical sign that must not be overlooked, as it may indicate the
presence of malignant lesions at an earlier stage.

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