Analysis Of Relevant Factors Of Benign And Malignant Intraductal Papillary Mucinous Neoplasm Of The Pancreas

Objective: To review and analyze the clinical data of 41 patients with IPMN diagnosed from January 2010 to January 2019.To explore the differences in clinical manifestations,laboratory examination and imaging examination between malignant and benign IPMN patients and study the related risk factors affecting the benign and malignant IPMN,so as to provide help for clinical diagnosis and treatment.Methods: To collect the data of IPMN patients confirmed by pathology in the Affiliated Hospital of Qingdao University from January 2010 to January2019,including general information,laboratory examination results,imaging results,histopathological results,etc.Excluding patients with severe medical diseases and other tumor diseases before surgery,as well as patients whose clinical data was missing,there are 41 patients whose clinical data met the inclusion requirements of this study.All cases were divided into malignant IPMN and benign IPMN groups according to the postoperative pathological diagnosis.For the continuous variables satisfying normal distribution or approximate normal distribution,independent sample t-test is used,which is expressed by mean ± sd;for the classified variables,chi-square test or Fisher exact test are used for analysis.For the risk factors related to malignant IPMN,single factor Logistic regression analysis was carried out,and the indicators with statistical significance of single factor analysis were included in the logistic model for multi factor regression analysis.P<0.05 was considered statistically significant.The statistical continuity variables were used to draw ROC curve analysis to calculate the cutoff value.Results:This study included 41 patients with IPMN,including 23 benign patients and 18 malignant patients,whose ages ranged from 37 to 82 years old,with an average age of(64.8±10.0)years old,including 28 males and 13 females,with a male-female ratio of 2.15:1.The clinical manifestations were upper abdominal pain in 15 cases,back pain in 10 cases,weight loss in 11 cases,jaundice in 6 cases,diarrhea in 2 cases,recurrent acute pancreatitis in 6cases,asymptomatic in 6 cases.According to the IPMN classification of the WHO,there were 12 main pancreatic duct types,21 branch pancreatic duct types and 8 mixed pancreatic duct types.The tumors were located in the head and uncinate process of pancreas in 31 cases,in the body and tail of pancreas in 8 cases,and in the whole pancreas in 2 cases.In the benign group,the maximum diameter of tumor was(4.31 ± 1.87)cm,the average maximum diameter of main pancreatic duct was(10.23 ± 2.16)mm.In the malignant group,the maximum diameter of tumor was(5.57 ± 1.07)cm,the average maximum diameter of main pancreatic duct was(11.94 ± 2.51)mm.There were no significant differences in gender,age,abdominal pain,back pain,diarrhea,recurrent acute pancreatitis,lesion classification,location of lesions,CEA,CA19-9,thickness of tumor capsule wall,lymph node metastasis and vascular invasion,tumor internal division,atrophy of pancreatic parenchyma and calcification between the benign and malignant groups(P > 0.05).There were significant differences in weight loss,jaundice,TBi L,tumor maximum diameter,main pancreatic duct maximum diameter,presence or absence of mural nodule and height of mural nodule(P < 0.05).The maximum diameter of tumor ? 4.34 cm,the sensitivity of malignant IPMN was 88.89%,the specificity was 73.91%;the maximum diameter of pancreatic duct expansion ?11.13 mm,the sensitivity of malignant IPMN was 61.11%,the specificity was78.26%,which was the best critical value for judging malignant tumor.Conclusions: IPMN is commonly found in middle-aged and elderly men,the most common clinical manifestation is upper abdominal pain.There were differences between benign and malignant IPMN in weight loss,jaundice,TBi L,the largest diameter of the tumor,the largest diameter of the main pancreatic duct,the presence or absence of mural nodules and the height of mural nodules.Jaundice,the largest diameter of the tumor and the largest diameter of the main pancreatic duct were independent risk factors for the prediction of malignant IPMN.The maximum diameter of tumor ?4.34 cm,the maximum diameter of pancreatic duct dilatation ?11.13 mm and jaundice may be the indicators for the prediction of malignant IPMN.