MRI-Based Pancreatic Atrophy Is Associated With Malignancy or Invasive Carcinoma in Intraductal Papillary Mucinous Neoplasm
BackgroundAbrupt change in the caliber of the main pancreatic duct (MPD) with distal pancreatic atrophy (PA) was considered as one of worrisome features in the International Association of Pancreatology guideline and American College of Gastroenterology guideline for the management of intraductal pa...
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| Format: | Article |
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Frontiers Media S.A.
2022-06-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.894023/full |
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| author | Tingting Lin Xin Chen Jingjing Liu Yingying Cao Wenjing Cui Zhongqiu Wang Cheng Wang Xiao Chen Xiao Chen |
| author_facet | Tingting Lin Xin Chen Jingjing Liu Yingying Cao Wenjing Cui Zhongqiu Wang Cheng Wang Xiao Chen Xiao Chen |
| author_sort | Tingting Lin |
| collection | DOAJ |
| description | BackgroundAbrupt change in the caliber of the main pancreatic duct (MPD) with distal pancreatic atrophy (PA) was considered as one of worrisome features in the International Association of Pancreatology guideline and American College of Gastroenterology guideline for the management of intraductal papillary mucinous neoplasms (IPMNs). However, this feature was not included in other guidelines. Moreover, the association between PA alone and malignancy in IPMNs has not been fully evaluated. In the present study, we investigated the role of image-based PA in identifying malignant IPMNs or invasive carcinoma.MethodsA total of 186 patients with IPMNs were included for analysis. The tumor size, location, MPD diameter, presence of a mural nodule (MN), and PA were evaluated using magnetic resonance imaging. Demographic information and serum carbohydrate antigen 19-9 and carcinoembryonic antigen (CEA) levels were also collected. IPMNs with high-grade dysplasia and associated invasive carcinoma were regarded as malignant IPMNs.ResultsPA was observed in 34 cases (18.3%). The occurrence of malignant IPMNs or invasive carcinoma in patients with PA were significantly higher than in those without PA (52.9% vs. 22.3%; 44.1% vs. 8.9%, all P < 0.01). Multivariate logistic regression analysis showed that PA was an independently associated factor for malignant IPMNs [odds ratio (OR) = 2.69, 95% confidence interval (CI): 1.07-6.78] or invasive carcinoma (OR = 7.78, 95%CI: 2.62-23.10) after modified with confounders. Subgroup analysis in MPD-involved IPMNs also indicated that PA was an independently associated factor for invasive carcinoma (OR = 9.72, 95%CI: 2.43-38.88). PA had a similar performance with MPD plus MN [the area under the curve (AUC) was both 0.71] in identifying malignancy. PA had a higher performance in identifying invasive carcinoma in MPD-involved IPMNs than MN (AUC = 0.71 vs. 0.65, P = 0.02).ConclusionOur data showed that imaging-based PA was associated with malignancy or invasive carcinoma regardless of abrupt change in the caliber of MPD in IPMNs. PA had an acceptable performance in identifying malignant IPMNs. |
| first_indexed | 2024-12-12T10:57:43Z |
| format | Article |
| id | doaj.art-e693d31f5c4144c3b6b53e7f8340ce73 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-12T10:57:43Z |
| publishDate | 2022-06-01 |
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| series | Frontiers in Oncology |
| spelling | doaj.art-e693d31f5c4144c3b6b53e7f8340ce732022-12-22T00:26:37ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-06-011210.3389/fonc.2022.894023894023MRI-Based Pancreatic Atrophy Is Associated With Malignancy or Invasive Carcinoma in Intraductal Papillary Mucinous NeoplasmTingting Lin0Xin Chen1Jingjing Liu2Yingying Cao3Wenjing Cui4Zhongqiu Wang5Cheng Wang6Xiao Chen7Xiao Chen8Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, ChinaDepartment of Radiology, Shanghai Sixth People’s Hospital, Shanghai, ChinaDepartment of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, ChinaDepartment of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, ChinaDepartment of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, ChinaDepartment of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, ChinaDepartment of Radiology, Nanjing Drum Tower Hospital, Nanjing, ChinaDepartment of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, ChinaInstitute of Radiation Medicine, Fudan University, Shanghai, ChinaBackgroundAbrupt change in the caliber of the main pancreatic duct (MPD) with distal pancreatic atrophy (PA) was considered as one of worrisome features in the International Association of Pancreatology guideline and American College of Gastroenterology guideline for the management of intraductal papillary mucinous neoplasms (IPMNs). However, this feature was not included in other guidelines. Moreover, the association between PA alone and malignancy in IPMNs has not been fully evaluated. In the present study, we investigated the role of image-based PA in identifying malignant IPMNs or invasive carcinoma.MethodsA total of 186 patients with IPMNs were included for analysis. The tumor size, location, MPD diameter, presence of a mural nodule (MN), and PA were evaluated using magnetic resonance imaging. Demographic information and serum carbohydrate antigen 19-9 and carcinoembryonic antigen (CEA) levels were also collected. IPMNs with high-grade dysplasia and associated invasive carcinoma were regarded as malignant IPMNs.ResultsPA was observed in 34 cases (18.3%). The occurrence of malignant IPMNs or invasive carcinoma in patients with PA were significantly higher than in those without PA (52.9% vs. 22.3%; 44.1% vs. 8.9%, all P < 0.01). Multivariate logistic regression analysis showed that PA was an independently associated factor for malignant IPMNs [odds ratio (OR) = 2.69, 95% confidence interval (CI): 1.07-6.78] or invasive carcinoma (OR = 7.78, 95%CI: 2.62-23.10) after modified with confounders. Subgroup analysis in MPD-involved IPMNs also indicated that PA was an independently associated factor for invasive carcinoma (OR = 9.72, 95%CI: 2.43-38.88). PA had a similar performance with MPD plus MN [the area under the curve (AUC) was both 0.71] in identifying malignancy. PA had a higher performance in identifying invasive carcinoma in MPD-involved IPMNs than MN (AUC = 0.71 vs. 0.65, P = 0.02).ConclusionOur data showed that imaging-based PA was associated with malignancy or invasive carcinoma regardless of abrupt change in the caliber of MPD in IPMNs. PA had an acceptable performance in identifying malignant IPMNs.https://www.frontiersin.org/articles/10.3389/fonc.2022.894023/fullpancreatic atrophyintraductal papillary mucinous neoplasmspancreasmalignancyinvasive carcinoma |
| spellingShingle | Tingting Lin Xin Chen Jingjing Liu Yingying Cao Wenjing Cui Zhongqiu Wang Cheng Wang Xiao Chen Xiao Chen MRI-Based Pancreatic Atrophy Is Associated With Malignancy or Invasive Carcinoma in Intraductal Papillary Mucinous Neoplasm Frontiers in Oncology pancreatic atrophy intraductal papillary mucinous neoplasms pancreas malignancy invasive carcinoma |
| title | MRI-Based Pancreatic Atrophy Is Associated With Malignancy or Invasive Carcinoma in Intraductal Papillary Mucinous Neoplasm |
| title_full | MRI-Based Pancreatic Atrophy Is Associated With Malignancy or Invasive Carcinoma in Intraductal Papillary Mucinous Neoplasm |
| title_fullStr | MRI-Based Pancreatic Atrophy Is Associated With Malignancy or Invasive Carcinoma in Intraductal Papillary Mucinous Neoplasm |
| title_full_unstemmed | MRI-Based Pancreatic Atrophy Is Associated With Malignancy or Invasive Carcinoma in Intraductal Papillary Mucinous Neoplasm |
| title_short | MRI-Based Pancreatic Atrophy Is Associated With Malignancy or Invasive Carcinoma in Intraductal Papillary Mucinous Neoplasm |
| title_sort | mri based pancreatic atrophy is associated with malignancy or invasive carcinoma in intraductal papillary mucinous neoplasm |
| topic | pancreatic atrophy intraductal papillary mucinous neoplasms pancreas malignancy invasive carcinoma |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.894023/full |
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