Clinicopathological Features of Malignant Intraductal Papillary Mucinous Tumors of the Pancreas

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Abstract
Selection of a surgical procedure for treating intraductal papillary mucinous tumors (IPMTs) still remains controversial, because IPMTs show a wide spectrum of histological characteristics, ranging from hyperplasia to invasive carcinoma.1-3 IPMTs are believed to have a favorable prognosis compared with ductal cell carcinoma.3-5 However, IPMTs have a poor prognosis when invasive carcinoma derived from IPMTs has developed.5-8 The biologic behavior of IPMTs remains unclear. Previous studies have been performed to differentiate malignant IPMTs from benign IPMTs by retrospective investigations of clinical data, imaging findings,1,9-15 cytologic analyses in pure pancreatic juice,16 or molecular analysis.17 Consequently, no consensus concerning early diagnosis of malignant IPMTs has been attained as yet. Moreover, a simultaneous analysis of these factors has not been performed, to our knowledge. We simultaneously retrospectively analyzed clinical data, imaging findings, cytologic analyses, and tumor markers in pure pancreatic juice. The aim of the present study was to determine preoperative factors that are predictive for the early diagnosis of malignant IPMTs.