Predictors of malignant intraductal papillary mucinous neoplasm of the pancreas

J Clin Gastroenterol. 2010 Oct;44(9):e224-9. doi: 10.1097/MCG.0b013e3181d8fb91.


Goals: The predictors of malignant intraductal papillary mucinous neoplasm (IPMN) and invasive IPMN were investigated in this study to determine the optimal indicators of surgical resection for IPMN.

Background: Recently, international consensus guidelines have described the standard indicators of resection for IPMN. However, the indicators of surgical resection for IPMN, especially for branch duct IPMN, still remain controversial.

Study: Eighty-two patients with IPMN who underwent surgical resection during April 1998 to January 2009, were retrospectively reviewed and examined with regard to their preoperative factors and pathologic diagnosis.

Results: Multivariate analysis showed that main duct IPMN (P<0.01) and earlier diabetes (P=0.03) were independent predictors of malignant IPMN. In branch duct IPMN, the diameter of the main pancreatic duct (MPD) was found to be significantly associated with malignancy by univariate analysis (P=0.034). An elevated serum CA19-9 level (P<0.01) was an independent predictor of invasive IPMN.

Conclusions: Our observations suggest that main duct IPMN, branch duct IPMN with MPD dilatation, and IPMN with an elevated serum CA19-9 level should be considered as indications for surgical resection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma, Mucinous / diagnosis
  • Adenocarcinoma, Mucinous / pathology*
  • Adenocarcinoma, Mucinous / surgery
  • Aged
  • Aged, 80 and over
  • CA-19-9 Antigen / blood
  • Carcinoma, Pancreatic Ductal / diagnosis
  • Carcinoma, Pancreatic Ductal / pathology*
  • Carcinoma, Pancreatic Ductal / surgery
  • Carcinoma, Papillary / diagnosis
  • Carcinoma, Papillary / pathology*
  • Carcinoma, Papillary / surgery
  • Consensus
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Pancreatectomy / methods
  • Pancreatic Neoplasms / diagnosis
  • Pancreatic Neoplasms / pathology*
  • Pancreatic Neoplasms / surgery
  • Practice Guidelines as Topic
  • Retrospective Studies


  • CA-19-9 Antigen