Proposed new score predicting malignancy of intraductal papillary mucinous neoplasms of the pancreas

Background Our objective was to predict malignancy for intraductal papillary mucinous neoplasms of the pancreas (IPMN) before operation. Methods Sixty-four resected patients with IPMN were examined and 17 parameters were investigated for their relation to malignancy by univariate and multivariate analysis. Results Multivariate logistic regression analysis showed that IPMN type, the size of main pancreatic duct, and serum carbohydrate antigen 19-9 were significant for malignancy. Size of the main pancreatic duct ≥6.5 mm and serum carbohydrate antigen 19-9 ≥35 U/mL scored 3 points, main duct type scored 2 points, and patulous papilla, jaundice, diabetes mellitus, and tumor size ≥42 mm scored 1 point. When IPMNs with 3 and more than 3 points using the new score were diagnosed as malignant, accuracy was 90.6%. Conclusion This scoring system for IPMN is feasible to detect malignancy and useful for selecting an appropriate treatment.