Evaluation of the Sendai and 2012 International Consensus Guidelines based on cross-sectional imaging findings performed for the initial triage of mucinous cystic lesions of the pancreas: a single institution experience with 114 surgically treated patients
| Autor: | Choon Hua Thng, Wai-Keong Wong, Jen-San Wong, Pierce K. H. Chow, London L.P.J. Ooi, Albert S. C. Low, Peng-Chung Cheow, Alexander Y. F. Chung, Brian K. P. Goh, Damien Tan |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Pathology Malignancy Gastroenterology Cystic lesion Carcinoembryonic antigen Predictive Value of Tests Internal medicine Biomarkers Tumor medicine Humans Aged Retrospective Studies Pancreatic duct Univariate analysis biology Intraductal papillary mucinous neoplasm business.industry General Medicine Middle Aged medicine.disease Adenocarcinoma Mucinous Triage Pancreatic Neoplasms Radiography Cross-Sectional Studies medicine.anatomical_structure Practice Guidelines as Topic biology.protein Female Surgery Pancreas business Carcinoma Pancreatic Ductal |
| Zdroj: | The American Journal of Surgery. 208:202-209 |
| ISSN: | 0002-9610 |
| Popis: | Background The Sendai Consensus Guidelines (SCG) were formulated in 2006 to guide the management of mucinous cystic lesions of the pancreas (CLPs) and were updated in 2012 (International Consensus Guidelines, ICG 2012). This study aims to evaluate the clinical utility of the ICG 2012 with the SCG based on initial cross-sectional imaging findings. Methods One hundred fourteen patients with mucinous CLPs were reviewed and classified according to the ICG 2012 as high risk (HR ICG2012 ), worrisome (W ICG2012 ), and low risk (LR ICG2012 ), and according to the SCG as high risk (HR SCG ) and low risk (LR SCG ). Results On univariate analysis, the presence of symptoms, obstructive jaundice, elevated serum carcinoembryonic antigen (CEA)/carbohydrate antigen (CA)19-9, solid component, main pancreatic duct ≥10 mm, and main pancreatic duct ≥5 mm was associated with high grade dysplasia/invasive carcinoma in all mucinous CLPs. Increasing number of HR SCG or HR ICG2012 features was associated with a significantly increased likelihood of malignancy. The positive predictive value of HR SCG and HR ICG2012 for high grade dysplasia/invasive carcinoma was 46% and 62.5% respectively. The negative predictive value of both LR SCG and LR ICG2012 was 100%. Conclusion Both the guidelines were useful in the initial cross-sectional imaging evaluation of mucinous CLPs. The ICG 2012 guidelines were superior to the SCG guidelines. |
| Databáze: | OpenAIRE |
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