Significance of pancreatic calcification on preoperative computed tomography of intraductal papillary mucinous neoplasms
Significance of pancreatic calcification on preoperative computed tomography of intraductal papillary mucinous neoplasms
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DOI：
10.1111/jgh.14732
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发表时间：
2019-09-01
影响因子：
4.1
通讯作者：
Kodama, Yuzo
中科院分区：
文献类型：
--
作者：
Tsujimae, Masahiro;Masuda, Atsuhiro;Kodama, Yuzo
背景和目的慢性胰腺炎是胰腺癌的危险因素。胰腺钙化是慢性胰腺炎的一个特征，然而，它对导管内乳头状粘液性肿瘤（IPMN）的意义尚不清楚。因此，我们研究胰腺钙化和侵袭性IPMN之间的关系。方法本研究纳入了2001年4月至2016年10月期间接受IPMN切除术的157例患者（导管内乳头状黏液性腺瘤，n = 76;非侵袭性导管内乳头状黏液性癌[IPMC]，n = 32;侵袭性IPMC，n = 49）。我们根据术前计算机断层扫描（CT）上胰腺钙化的存在/不存在对受试者进行分类。在单变量分析中研究了与胰腺钙化相关的因素。然后，对胰腺钙化和侵袭性IPMC之间的关系进行多变量logistic回归分析（调整临床或影像学特征后）。结果术前CT显示胰腺钙化占17.2%（27/157）。在单变量分析中，黄疸、高血清碳水化合物抗原19-9水平和侵袭性IPMC与胰腺钙化显著相关（4/27 [14.8%] vs 4/130 [3.1%]，0.01; 12/27 [44.4%] vs 31/130 [23.8%]，0.03; 15/27 [55.6%] vs 34/130 [26.2%]，0.001）。胰腺钙化与侵袭性IPMC显著相关（多变量比值比= 2.88，95%置信区间[95% CI] = 1.15-7.21，0.03，根据临床特征调整;比值比= 5.50，95% CI = 1.98-15.3，0.001，根据影像学特征调整）。结论胰腺CT钙化与胰腺浸润性胰腺癌有关。胰腺钙化可能是侵袭性IPMC的预测因子。
Background and Aim Chronic pancreatitis is a risk factor for pancreatic cancer. Pancreatic calcification is a characteristic of chronic pancreatitis; however, its significance for intraductal papillary mucinous neoplasm (IPMN) oncogenesis remains unknown. Therefore, we investigated the relationship between pancreatic calcification and invasive IPMN. Methods This study included 157 patients who underwent resection for IPMN between April 2001 and October 2016 (intraductal papillary mucinous adenoma, n = 76; noninvasive intraductal papillary mucinous carcinoma [IPMC], n = 32; and invasive IPMC, n = 49). We divided the subjects on the basis of the presence/absence of pancreatic calcification on preoperative computed tomography (CT). The factors associated with pancreatic calcification were investigated in univariate analyses. Then, multivariate logistic regression analyses of the relationship between pancreatic calcification and invasive IPMC (after adjusting for clinical or imaging characteristics) were conducted. Results Preoperative CT revealed pancreatic calcification in 17.2% (27/157) of the resected IPMN. In the univariate analyses, jaundice, high serum carbohydrate antigen 19-9 levels, and invasive IPMC were significantly associated with pancreatic calcification (4/27 [14.8%] vs 4/130 [3.1%], 0.01; 12/27 [44.4%] vs 31/130 [23.8%], 0.03; and 15/27 [55.6%] vs 34/130 [26.2%], 0.001, respectively). Pancreatic calcification was significantly associated with invasive IPMC (multivariate odds ratio = 2.88, 95% confidence interval [95% CI] = 1.15-7.21, 0.03, adjusted for clinical characteristics; odds ratio = 5.50, 95% CI = 1.98-15.3, 0.001, adjusted for imaging characteristics). Conclusions Pancreatic calcification on CT is associated with invasive IPMC. Pancreatic calcification might be a predictor of invasive IPMC.