• Tae Hyeon Kim, Tae Jun Song, Jin-Hyeok Hwang, Kyo-Sang Yoo, Woo-Jin Lee, Kwang-Hyuck Lee, Seok-Ho Dong, Chang-Hwan Park, Eun-Taek Park, Jong-Ho Moon, Ho-Gak Kim, Eun-Young Kim, Kwang Bum Cho, Hong-Ja Kim, Seung-Ok Lee, Young Koog Cheon, Jeong Mi Lee, Dong Wook Oh, and Myung-Hwan Kim.
• Department of Internal Medicine, Wonkwang University College of Medicine, Iksan, Republic of Korea.
• Pancreatology. 2015 Jul 1; 15 (4): 405-10.

Background/ObjectivesPrediction of malignancy in patients with BD-IPMNs is critical for the management. The aim of this study was to elucidate predictors of malignancy in patients with 'pure' BD-IPMNs who had a main pancreatic duct (MPD) diameter of ≤5 mm according to the most recent international consensus criteria and in whom MPD involvement was excluded on postoperative histology.MethodsWe identified 177 patients with 'pure' BD-IPMNs based on preoperative imaging and postoperative histology from 15 tertiary referral centers in Korea. BD-IPMNs with low-grade (n = 72) and moderate-grade (n = 66) dysplasia were grouped as benign and BD-IPMNs with high-grade dysplasia (n = 10) and invasive carcinoma (n = 29) were grouped as malignancy.ResultsOn univariate analysis, particular symptoms (jaundice and clinical pancreatitis), CT findings (cyst size > 3 cm, the presence of enhancing mural nodules) and EUS features (the presence of mural nodules, the mural nodule size > 5 mm) were significant risk factors predicting malignant BD-IPMNs. Multivariate analysis revealed that the cyst size > 3 cm (odds ratio = 9.9), the presence of enhancing mural nodules on CT (odds ratio = 19.3) and the mural nodule size > 5 mm on EUS (odds ratio = 14.9) were the independent risk factors for the presence of malignancy in BD-IPMNs (p < 0.001).ConclusionsThe cyst size > 3 cm, the presence of enhancing mural nodules on CT, the mural nodule size > 5 mm on EUS are three independent predictors of malignancy in patients with 'pure' BD-IPMNs.Copyright © 2015. Published by Elsevier B.V.

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