W1417 Extrapancreatic Malignancies in Patients with Intraductal Papillary Mucinous Neoplasm of the Pancreas - Incidence, Risk Factors, and Comparison with Patients with Other Pancreatic Cystic Neoplasms

204 Background: Previous studies have analyzed that inflammatory markers, such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and advanced lung cancer inflammation index (ALI), associated with the presence of invasive carcinoma in patients with intraductal papillary mucinous neoplasm (IPMN). This study aimed to evaluate the correlation between the inflammatory markers and the invasive carcinoma in IPMN and propose a nomogram including inflammatory markers for predicting invasive IPMN. Methods: From 1995 to 2016, total 468 patients who underwent surgical resection at four institutions for histologically confirmed IPMN and the data were reviewed retrospectively. The patients with history of pancreatitis, other malignancies and without CA19-9 data or lymphocyte counts were excluded, the study cohort consisted of 365 patients. Variables with P < 0.05 in risk factor analysis were included in the nomogram. Results: Of 365 patients, 98 (26.8%) patients had invasive IPMN. In univariate analysis, high body mass index (BMI) ( P = 0.037), pre-operative bilirubin level ( P = 0.001), CA19-9 ( P < 0.001), NLR ( P = 0.019), PLR ( P = 0.002), ALI ( P = 0.001), main duct type (P < 0.001), the presence of solid portion ( P < 0.001) and tumor size (P = 0.086) were identified as risk factors for invasive IPMN. In multivariate analysis, pre-operative bilirubin level (P = 0.003), CA19-9 (P = 0.002), main duct type (P = 0.034) and the presence of solid portion (P < 0.001) were independent predictive markers for invasive IPMN. The nomogram was developed including all factors of risk factor analysis. Conclusions: The inflammatory markers were the risk factors for the presence of IPMN-associated invasive carcinoma. This nomogram may be useful in identifying patients with IPMN at risk of malignancy and for selecting which patients should undergo surgery. Further validation studies are needed to assess the predictive ability of nomogram including inflammatory markers.

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P-171 Risk Factors of Progression or Malignancy in Main Duct and Mixed-type Intraductal Papillary Mucinous Neoplasm of the Pancreas

Annals of Oncology ◽

10.1093/annonc/mdv233.171 ◽

2015 ◽

Vol 26 ◽

pp. iv49

Author(s):

S.H. Lee ◽

D.K. Jang ◽

J. Ryu ◽

Y.-T. Kim

Keyword(s):

Risk Factors ◽

Intraductal Papillary Mucinous Neoplasm ◽

Mixed Type ◽

Main Duct ◽

Mucinous Neoplasm

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Intraductal Oncocytic Papillary Neoplasms of the Pancreas

Archives of Pathology & Laboratory Medicine ◽

10.5858/arpa.2014-0595-rs ◽

2016 ◽

Vol 140 (9) ◽

pp. 992-996 ◽

Cited By ~ 5

Author(s):

Michael E. Kallen ◽

Bita V. Naini

Keyword(s):

Differential Diagnosis ◽

Molecular Genetics ◽

Intraductal Papillary Mucinous Neoplasm ◽

Biliary Tree ◽

Limited Data ◽

Cystic Neoplasms ◽

Clinical Behavior ◽

Intraductal Growth ◽

Mucinous Neoplasm ◽

Histologic Subtypes

Intraductal oncocytic papillary neoplasms (IOPNs) are cystic neoplasms with intraductal growth and complex papillae composed of oncocytic cells. IOPNs have been reported both in the pancreas and biliary tree, and are most likely closely related in these 2 locations. In the pancreas, these rare tumors are now considered 1 of the 4 histologic subtypes of intraductal papillary mucinous neoplasm (IPMN). Significant differences in histology, immunophenotype, and molecular genetics have been reported between IOPNs and other IPMN subtypes. However, there are limited data regarding the clinical behavior and prognosis of IOPNs in comparison to other subtypes of IPMN. We review features of pancreatic IOPNs and discuss the differential diagnosis of other intraductal lesions in the pancreas.

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