Online calculator for predicting the risk of malignancy in patients with pancreatic cystic neoplasms: A multicenter, retrospective study

doi:10.3748/wjg.v28.i37.5469

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Gastroenterol. Oct 7, 2022; 28(37): 5469-5482
Published online Oct 7, 2022. doi: 10.3748/wjg.v28.i37.5469

Table 1 Preoperative clinical characteristics of patients with pancreatic cystic neoplasms

Characteristics	Training cohort	Validation cohort	P value
Characteristics	n = 187 (64.5%)	n = 103 (35.5%)	P value
Sex			0.190
Male	126 (67.4)	77 (74.8)
Female	61 (32.6)	26 (25.2)
Age in yr			0.344
< 60	123 (65.8)	62 (60.2)
≥ 60	64 (34.2)	41 (39.8)
BMI	23.25 ± 3.37	23.00 ± 3.53	0.561
Weight loss			0.830
No	165 (88.2)	90 (87.4)
Yes	22 (11.8)	13 (12.6)
Alcohol			0.378
No	168 (89.8)	89 (86.4)
Yes	19 (10.2)	14 (13.6)
Symptomatic			0.602
No	74 (39.6)	44 (42.7)
Yes	113 (60.4)	59 (57.3)
NLR			0.510
< 2.288	134 (71.7)	70 (68.0)
≥ 2.288	53 (28.3)	33 (32.0)
TB in μmol/L			0.763
< 34.2	181 (96.8)	99 (96.1)
≥ 34.2	6 (3.2)	4 (3.9)
CEA in ng/mL			0.901
< 5	175 (93.6%)	96 (96.0%)
≥ 5	12 (6.4)	7 (7.0)
CA19-9 in U/mL			0.135
< 34	163 (87.2)	83 (80.6)
≥ 34	24 (12.8)	20 (19.4)
GGT in IU/L			0.287
< 150	174 (93.0)	99 (96.1)
≥ 150	13 (7.0)	4 (3.9)
ALP in IU/L			0.556
< 200	179 (95.7)	97 (94.2)
≥ 200	8 (4.3)	6 (5.8)

ALP: Alkaline phosphatase; BMI: Body mass index; CA19-9: Carbohydrate antigen 19-9; CEA: Carcinoembryonic antigen; GGT: γ-glutamyl transpeptidase; NLR: Neutrophil-to-lymphocyte; TB: Total bilirubin.

Table 2 Preoperative imaging characteristics of patients with pancreatic cystic neoplasms

Characteristic	Training cohort	Validation cohort	P value
Characteristic	n = 187 (64.5%)	n = 103 (35.5%)	P value
Tumor involve the head of pancreas			0.239
Yes	65 (34.8)	43 (41.7)
No	122 (65.2)	60 (58.3)
Bile duct dilation			0.106
No	174 (93.0)	90 (87.4)
Yes	13 (7.0)	13 (12.6)
Tumor size in mm			0.254
< 40	158 (84.5)	92 (89.3)
≥ 40	29 (15.5)	11 (10.7)
Intratumoral septum			0.264
No	76 (40.6)	35 (34.0)
Yes	111 (59.4)	68 (66.0)
Cyst wall enhancement			0.244
No	118 (63.1)	72 (69.9)
Yes	69 (36.9)	31 (30.1)
Cyst wall thickening			0.709
No	178 (95.2)	97 (94.2)
Yes	9 (4.8)	6 (5.8)
Enhanced mural nodules			0.126
No	148 (79.1)	89 (86.4)
Yes	39 (20.9)	14 (13.6)
Intracapsular calcification			0.117
No	162 (86.6)	82 (79.6)
Yes	25 (13.4)	21 (20.4)
Main pancreatic duct dilatation			0.419
No	122 (65.2)	72 (69.9)
Yes	65 (34.8)	31 (30.1)

Table 3 Univariable and multivariable logistic regression analyses of the risk factors for high risk of malignancy in patients with pancreatic cystic neoplasms

Variable	OR comparisons	Univariable analysis		Multivariable analysis
Variable	OR comparisons	OR (95%CI)	P value	OR (95%CI)	P value
Sex	Female vs Male	2.383 (1.054-5.386)	0.037^a	0.716 (0.232-2.213)	0.562
Age in yr	≥ 60 vs < 60	2.180 (0.967-4.915)	0.060
BMI		0.986 (0.874-1.111)	0.816
Weight loss	Yes vs No	2.437 (0.861-6.897)	0.093
Alcohol	Yes vs No	2.252 (0.741-6.845)	0.153
Symptomatic	Yes vs No	1.774 (0.737-4.271)	0.201
Tumor involve the head of pancreas	Yes vs No	1.148 (0.487-2.705)	0.753
Bile duct dilation	Yes vs No	1.788 (0.460-6.952)	0.402
Tumor diameter in mm	≥ 40 vs < 40	4.094 (1.649-10.165)	0.002^a	3.514 (1.138-10.849)	0.029^a
Intratumoral septum	Yes vs No	0.539 (0.240-1.211)	0.135
Cyst wall enhancement	Yes vs No	1.127 (0.494-2.569)	0.777
Cyst wall thickening	Yes vs No	1.670 (0.329-8.488)	0.536
Enhanced mural nodules	Yes vs No	6.490 (2.746-15.342)	< 0.001^a	4.314 (1.618-11.503)	0.003^a
Intracapsular calcification	Yes vs No	0.208 (0.027-1.606)	0.132
Main pancreatic duct dilatation	Yes vs No	3.574 (1.558-8.201)	0.003^a	3.267 (1.230-8.678)	0.018^a
NLR	≥ 2.288 vs < 2.288	3.077 (1.350-7.015)	0.008^a	2.702 (1.008-7.244)	0.048^a
TB in μmol/L	≥ 34.2 vs < 34.2	6.240 (1.192-32.657)	0.030^a	0.870 (0.050-15.020)	0.924
ALP in IU/L	≥ 200 vs < 200	9.420 (1.499-59.213)	0.017^a	0.632 (0.064-6.285)	0.695
GGT in IU/L	≥ 150 vs < 150	2.925 (0.931-9.189)	0.066
CEA in ng/mL	≥ 5 vs < 5	6.955 (2.060-23.477)	0.002^a	3.798 (0.825-17.482)	0.087
CA199 in U/mL	≥ 34 vs < 34	4.547 (1.750-11.816)	0.002^a	3.267 (1.274-13.007)	0.018^a

^aP < 0.05.

ALP: Alkaline phosphatase; BMI: Body mass index; CA19-9: Carbohydrate antigen 19-9; CEA: Carcinoembryonic antigen; CI: Confidence interval; GGT: γ-glutamyl transpeptidase; NLR: Neutrophil-to-lymphocyte; OR: Odds ratio; TB: Total bilirubin.

Citation: Jiang D, Chen ZX, Ma FX, Gong YY, Pu T, Chen JM, Liu XQ, Zhao YJ, Xie K, Hou H, Wang C, Geng XP, Liu FB. Online calculator for predicting the risk of malignancy in patients with pancreatic cystic neoplasms: A multicenter, retrospective study. World J Gastroenterol 2022; 28(37): 5469-5482
URL: https://www.wjgnet.com/1007-9327/full/v28/i37/5469.htm
DOI: https://dx.doi.org/10.3748/wjg.v28.i37.5469