학술논문
A scoring system for predicting malignancy in intraductal papillary mucinous neoplasms of the pancreas: a multicenter EUROPEAN validation.
Document Type
Article
Author
Manuel-Vázquez, Alba; Balakrishnan, Anita; Agami, Paul; Andersson, Bodil; Berrevoet, Frederik; Besselink, Marc G.; Boggi, Ugo; Caputo, Damiano; Carabias, Alberto; Carrion-Alvarez, Lucia; Franco, Carmen Cepeda; Coppola, Alessandro; Dasari, Bobby V. M.; Diaz-Mercedes, Sherley; Feretis, Michail; Fondevila, Constantino; Fusai, Giuseppe Kito; Garcea, Giuseppe; Gonzabay, Victor; Bravo, Miguel Ángel Gómez
Source
Subject
*PANCREAS
*TUMORS
*SENSITIVITY & specificity (Statistics)
*FORECASTING
*PANCREATIC surgery
*
*
*
*
Language
ISSN
1435-2443
Abstract
Purpose: A preoperative estimate of the risk of malignancy for intraductal papillary mucinous neoplasms (IPMN) is important. The present study carries out an external validation of the Shin score in a European multicenter cohort. Methods: An observational multicenter European study from 2010 to 2015. All consecutive patients undergoing surgery for IPMN at 35 hospitals with histological-confirmed IPMN were included. Results: A total of 567 patients were included. The score was significantly associated with the presence of malignancy (p < 0.001). In all, 64% of the patients with benign IPMN had a Shin score < 3 and 57% of those with a diagnosis of malignancy had a score ≥ 3. The relative risk (RR) with a Shin score of 3 was 1.37 (95% CI: 1.07–1.77), with a sensitivity of 57.1% and specificity of 64.4%. Conclusion: Patients with a Shin score ≤ 1 should undergo surveillance, while patients with a score ≥ 4 should undergo surgery. Treatment of patients with Shin scores of 2 or 3 should be individualized because these scores cannot accurately predict malignancy of IPMNs. This score should not be the only criterion and should be applied in accordance with agreed clinical guidelines. [ABSTRACT FROM AUTHOR]