Comparison of the diagnostic accuracy of three current guidelines for the evaluation of asymptomatic pancreatic cystic neoplasms

Medicine (United States) - Tập 96 Số 35 - Trang e7900 - 2017
Mingming Xu1,2,3,4,5,6,7,8,9,10, Shi Yin1,2,3,4,5,6,7,8,9,10, Ali H. Mokdad1,2,3,4,5,6,7,8,9,10, Ronald R. Salem1,2,3,4,5,6,7,8,9,10, Beth Schrope1,2,3,4,5,6,7,8,9,10, Amrita Sethi1,2,3,4,5,6,7,8,9,10, John M. Poneros1,2,3,4,5,6,7,8,9,10, Frank G. Gress1,2,3,4,5,6,7,8,9,10, Jeanine M. Genkinger1,2,3,4,5,6,7,8,9,10, Catherine Do1,2,3,4,5,6,7,8,9,10, Christian Brooks1,2,3,4,5,6,7,8,9,10, John A. Chabot1,2,3,4,5,6,7,8,9,10, Michael D. Kluger1,2,3,4,5,6,7,8,9,10, Thomas E. Kowalski1,2,3,4,5,6,7,8,9,10, David E. Loren1,2,3,4,5,6,7,8,9,10, Harry R. Aslanian1,2,3,4,5,6,7,8,9,10, James J. Farrell1,2,3,4,5,6,7,8,9,10, Tamas A. Gonda11
1Asymptomatic pancreatic cysts are a common clinical problem but only a minority of these cases progress to cancer.
2Current management guidelines vary in their threshold recommendations for resection of suspected mucinous cystic neoplasms (MCN) and branch-duct intraductal papillary mucinous neoplasms (BD-IPMNs).
3Cyst size greater than 3 cm and advanced age were significant independent predictors of malignancy on resection.
4No single guideline provided high sensitivity for detection of malignant cyst without also increasing the false-positive rate.
5Study highlights.
6Supplemental Digital Content is available for this article.
7Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.md-journal.com).
8The stringent resection criteria of the AGA guidelines led to a high rate of missed cancers with lower sensitivity for detecting HGD and cancer compared to the 2012 Fukuoka and 2010 American College of Radiology guidelines.
9What is current knowledge.
10What is new here.
11Tamas A. Gonda, Division of Digestive and Liver Diseases, Columbia University Medical Center, New York, NY, USA (e-mail: [email protected]).

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Medicine (United States)

Tập 96 Số 35

e7900

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