https://scholars.lib.ntu.edu.tw/handle/123456789/557919
標題: | Validation of Indications for Surgery of European Evidence-Based Guidelines for Patients with Pancreatic Intraductal Papillary Mucinous Neoplasms | 作者: | I-SHIOW JAN MING-CHU CHANG CHING-YAO YANG YU-WEN TIEN YUNG-MING JENG CHIH-HORNG WU BANG-BIN CHEN YU-TING CHANG |
公開日期: | 2020 | 出版社: | Springer | 卷: | 24 | 期: | 11 | 起(迄)頁: | 2536-2543 | 來源出版物: | Journal of Gastrointestinal Surgery | 摘要: | Background: Which patients with pancreatic intraductal papillary mucinous neoplasms (IPMNs) should undergo surgical intervention remains a controversial issue. The aim of this retrospective study was to validate the new European evidence-based guidelines on pancreatic cystic neoplasms (EEBGPCN) for the management of IPMNs. Methods: One hundred fifty-eight patients with resected IPMNs at National Taiwan University Hospital between January 1994 and December 2016 were enrolled. Clinical information, including new-onset diabetes mellitus (DM) and preoperative CA 19-9 levels, were collected. All patients were stratified into three groups—absolute, relative indications, and conservative approach—according to EEBGPCN. The performance characteristics of EEBGPCN for high-grade dysplasia (HGD)/invasive carcinoma (IC) of IPMNs were calculated. Results: One hundred seven (67.7%) patients with low-grade dysplasia and 51 patients with HGD/IC, including 10 HGD and 41 IC, were analyzed. The missed rate for HGD/IC by EEBGPCN was 1.9% (3/158). The sensitivity, specificity, positive and negative predictive values, and accuracy of the absolute or relative indications for resecting IPMN according to EEBGPCN were 94.1%, 28.0%, 38.4%, 90.9%, and 49.4%. Jaundice, enhancing mural nodule < 5 mm, cyst diameter > 40 mm, increased levels of serum CA 19-9, new-onset DM, and main pancreatic duct dilation were associated with HGD/IC. Conclusions: The missed rate for HGD/IC is low by EEBGPCN. Increased serum CA 19-9 and new-onset DM in EEBGPCN were verified as the indications for the surgical resection of IPMNs. ? 2019, The Society for Surgery of the Alimentary Tract. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85076005560&doi=10.1007%2fs11605-019-04420-9&partnerID=40&md5=92e436d8d9bda274591797b3e9f7ef97 https://scholars.lib.ntu.edu.tw/handle/123456789/557919 |
ISSN: | 1091-255X | DOI: | 10.1007/s11605-019-04420-9 | SDG/關鍵字: | colloid carcinoma; human; pancreas carcinoma; pancreas tumor; retrospective study; Taiwan; Adenocarcinoma, Mucinous; Carcinoma, Pancreatic Ductal; Humans; Pancreatic Intraductal Neoplasms; Pancreatic Neoplasms; Retrospective Studies; Taiwan |
顯示於: | 醫學系 |
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