Abstract
Backround
The risk assessment of intraductal papillary mucinous neoplasms (IPMN) to either guide
patients to surgical resection or watchful waiting is still under debate. Additional
markers to better separate low and high-risk lesions would improve patient selection.
Methods
Patients who underwent pancreatic resections for IPMNs between January 2008 and December
2012 with available blood samples were selected and retrospectively assessed. Data
on cyst characteristics such as cyst size, duct relation and main-duct dilatation
were collected and plasma fibrinogen levels were measured.
Results
A total of 73 patients fulfilled the inclusion criteria by pancreatic resection for
pathologically confirmed IPMN and available blood sample. Histologically, IPMNs were
classified as low-grade and borderline in 52 (71.2%, group 1) and as high-grade and
invasive in 21 (28.8%, group 2) of all cases. Fibrinogen levels showed significant
differences between the two groups (group 1: mean 3.62 g/L (SD ± 1.14); group 2: mean
4.49 g/L (SD ± 1.57); p = 0.027). A ROC-curve analysis calculated cut-off value of
4.71 g/L separated groups 1 and 2 (p = 0.008). Fibrinogen levels remained as the only
significant factor in multivariable analysis, cyst size and duct relation were not
significant.
Conclusion
Blood fibrinogen differed between low and high risk IPMNs and therefore, the use of
fibrinogen as an additional discriminator in the pre-operative risk assessment of
IPMNs should be further evaluated.
Keywords
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Article info
Publication history
Published online: January 16, 2017
Accepted:
December 16,
2016
Identification
Copyright
© 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
