Proposed new score predicting malignancy of intraductal papillary mucinous neoplasms of the pancreas

Background: Our objective was to predict malignancy for intraductal papillary mucinous neoplasms of the pancreas (IPMN) before operation. Methods: Sixty-four resected patients with IPMN were examined and 17 parameters were investigated for their relation to malignancy by univariate and multivariate analysis. Results: Multivariate logistic regression analysis showed that IPMN type, the size of main pancre.atic duct, and serum carbohydrate antigen 19-9 were significant for malignancy. Size of the main pancreatic duct >= 6.5 mm and serum carbohydrate antigen 19-9 >= 35 U/mL scored 3 points, main duct type scored 2 points, and patulous papilla, jaundice, diabetes mellitus, and tumor size >= 42 nun scored I point. When IPMNs with 3 and more than 3 points using the new score were diagnosed as malignant, accuracy was 90.6%. Conclusion: This scoring system for IPMN is feasible to detect malignancy and useful for selecting an appropriate treatment. (c) 2007 Excerpta Medica Inc. All rights reserved.