학술논문
A scoring system for predicting malignancy in intraductal papillary mucinous neoplasms of the pancreas: a multicenter EUROPEAN validation
Document Type
Original Paper
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; Gorris, Myrte; Hendrikx, Bart; Hidalgo-Salinas, Camila; Kadam, Prashant; Karavias, Dimitrios; Kauffmann, Emanuele; Kourdouli, Amar; La Vaccara, Vincenzo; van Laarhoven, Stijn; Leighton, James; Liem, Mike S. L.; Machairas, Nikolaos; Magouliotis, Dimitris; Mahmoud, Adel; Marino, Marco V.; Massani, Marco; Requena, Paola Melgar; Mentor, Keno; Napoli, Niccolò; Nijhuis, Jorieke H. T.; Nikov, Andrej; Nistri, Cristina; Nunes, Victor; Ruiz, Eduardo Ortiz; Pandanaboyana, Sanjay; Saborido, Baltasar Pérez; Pohnán, Radek; Popa, Mariuca; Pérez, Belinda Sánchez; Bueno, Francisco Sánchez; Serrablo, Alejandro; Serradilla-Martín, Mario; Skipworth, James R. A.; Soreide, Kjetil; Symeonidis, Dimitris; Zacharoulis, Dimitris; Zelga, Piotr; Aliseda, Daniel; Santiago, María Jesús Castro; Mancilla, Carlos Fernández; Fragua, Raquel Latorre; Hughes, Daniel Llwyd; Llorente, Carmen Payá; Lesurtel, Mickaël; Gallagher, Tom; Ramia, José Manuel
Source
Langenbeck's Archives of Surgery. 407(8):3447-3455
Subject
Language
English
ISSN
1435-2451
Abstract
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.