The Ratio of C-Reactive Protein to Albumin Is an Independent Predictor of Malignant Intraductal Papillary Mucinous Neoplasms of the Pancreas
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | Whole Cohort (n = 83) |
---|---|
Sex, male n, % | 45 (54%) |
Female n,% | 38 (46%) |
Age, median (IQR range), y | 69 (62–76) |
IPMN type, n (%) | |
MD_IPMNs | 40 (48%) |
BD_IPMNs | 10 (12%) |
Combined type_IPMNs | 33 (40%) |
Surgical procedure n (%) | |
Pancreaticoduodenectomy | 50 (60%) |
Distal pancreatectomy + splenectomy | 22 (27%) |
Spleen-preserving distal pancreatectomy | 7 (9%) |
Central pancreatectomy | 1 (1%) |
Total pancreatectomy | 1 (1%) |
Tumor enucleation | 2 (2%) |
Histological grade, n (%) | |
Low-grade dysplasia | 30 (36%) |
Intermediate dysplasia | 7 (8%) |
High-grade dysplasia | 7 (8%) |
Invasive carcinoma | 39 (47%) |
High-risk stigmata n (%) | |
Obstructive jaundice | 18 (22%) |
Enhancing solid component | 47 (57%) |
MPD ≥ 10 mm | 12 (14%) |
Worrisome features n (%) | |
Tumor ≥ 3 cm | 26 (31%) |
Pancreatitis | 22 (27%) |
Enhancing cyst wall | 23 (28%) |
MPD 5–9 mm | 38 (46%) |
Abrupt change in caliber of pancreatic duct with distal pancreatic atrophy | 39 (47%) |
Univariate | Multivariate | ||||
---|---|---|---|---|---|
Variables | Benign IPMNs (n = 37) | Malignant IPMNs (n = 46) | p Value | OR (95% CI) | p Value |
Sex, male n (%) | 22 (59.46%) | 23 (50%) | 0.39 | NC | |
Age, median (IQR) | 67.5 (62–73.5) | 71 (62–78) | 0.18 | NC | |
Abdominal pain n (%) | 21 (56.76%) | 18 (39.13%) | 0.12 | NC | |
Dyspepsia n (%) | 21 (56.76%) | 17 (36.96%) | 0.181 | NC | |
Cephalic location n (%) | 27 (72.97%) | 27 (58.70%) | 0.175 | NC | |
Compression syndrome n (%) | 13 (35.14%) | 7 (15.22%) | 0.093 | NC | |
Tumor size cm, median (IQR) | 2 (1.8–3) | 2.8 (2–3.2) | 0.084 | NC | |
MPD diameter mm, median (IQR) | 6 (3–8) | 7 (4–8) | 0.14 | NC | |
Cyst diameter cm, median (IQR) | 3 (2–4) | 3 (2–4) | 0.69 | NC | |
High-risk stigmata, n (%) | |||||
Obstructive jaundice | 13 (35.14%) | 5 (10.87%) | 0.022 | 0.37 (0.08–0.158) | 0.18 |
Enhancing mural nodule | 25 (67.57%) | 22 (47.83%) | 0.09 | NC | |
MPD > 10 mm | 7 (18.92%) | 5 (10.87%) | 0.54 | NC | |
Worrisome features, n (%) | |||||
Cyst size > 3 cm | 12 (32.43%) | 14 (30.43%) | 0.97 | NC | |
Pancreatitis | 13 (35.14%) | 9 (19.57%) | 0.27 | NC | |
Enhancing cyst wall | 10 (27.03%) | 13 (28.26%) | 0.71 | NC | |
MPD 5–10 mm | 17 (45.95%) | 21 (45.65%) | 0.96 | NC | |
Abrupt change in caliber of pancreatic duct with distal pancreatic atrophy | 17 (45.95%) | 22 (47.83%) | 0.39 | NC | |
CA19.9, median (IQR) | 4 (2–11) | 24 (4–253) | 0.42 | NC | |
CEA, median (IQR) | 1 (0–3) | 2 (1–5) | 0.17 | NC | |
mGps | NC | ||||
0 | 31 (83.78%) | 37 (80.43%) | 0.46 | ||
1 | 4 (10.81%) | 4 (8.70%) | 0.52 | ||
2 | 2 (5.41%) | 5 (10.87%) | 0.32 | ||
NLR | NC | ||||
<2.38 | 17 (45.95%) | 24 (52.17%) | 0.573 | ||
>2.38 | 20 (54.05%) | 22 (47.83%) | |||
PLR | NC | ||||
<185.5 n % | 28 (75.68%) | 29 (63.04%) | 0.217 | ||
≥185.5 n % | 9 (24.32%) | 17 (36.96%) | |||
CAR | |||||
<0.083 n % | 31 (83.78%) | 22 (47.83%) | 0.001 | 7.9 (2.01–31.83) | 0.003 |
≥0.083 n % | 6 (16.22%) | 24 (52.17%) | |||
PNI | NC | ||||
<42.05 n % | 14 (37.84%) | 26 (56.52%) | 0.15 | ||
>42.05 n % | 23 (62.16%) | 20 (43.48%) | 0.07 |
Variables | CAR ≤ 0.083 (n 53) | CAR ≥ 0.083 (n 30) | p Value |
---|---|---|---|
Sex, male n, % | 28 (52.83%) | 17 (56.67) | 0.46 |
Age, median (IQR) | 69.5 (63–76.5) | 68 (61–75) | 0.42 |
Abdominal pain n, % | 27 (50.94%) | 12 (41.38%) | 0.28 |
Dyspepsia n, % | 28 (52.83%) | 10 (35.71%) | 0.11 |
Cephalic location n, % | 36 (67.92%) | 18 (60%) | 0.31 |
Compression syndrome n, % | 13 (25%) | 7 (25.93%) | 0.57 |
Tumour size cm, median (IQR) | 3 (2–3.75) | 2.5 (1.8–3.3) | 0.06 |
MPD diameter mm, median (IQR) | 6 (4–9) | 5.5 (3.5–7.5) | 0.12 |
Cyst diameter cm, median (IQR) | 3 (2–4) | 2.6 (2–3.8) | 0.26 |
High risk stigmata, n (%) | |||
Obstructive jaundice | 12 (22.64%) | 6 (20%) | 0.5 |
Enhancing mural nodule | 31 (62%) | 16 (53.33%) | 0.3 |
MPD >10 mm | 10 (20.41%) | 2 (7.14%) | 0.11 |
Worrisome features n (%) | |||
Cyst size >3 cm | 20 (38.46%) | 6 (20.69%) | 0.08 |
Pancreatitis | 15 (29.41%) | 7 (23.33%) | 0.37 |
Enhancing cyst wall | 16 (31.37%) | 7 (25%) | 0.37 |
MPD 5–10 mm | 22 (44.9%) | 16 (57.14%) | 0.21 |
Abrupt change in calibre of pancreatic duct with distal pancreatic atrophy | 24 (48.98%) | 15 (53.57%) | 0.44 |
CA19.9, median (IQR) | 8.5 (2–39) | 17.5 (3–107) | 0.24 |
CEA, median (IQR) | 1 (0.4–3) | 2 (1–4.5) | 0.27 |
Inflammatory biomarkers | |||
Neutrophils, median (IQR) | 3.7 (2.9–4.7) | 3.55 (2.9–5.3) | 0.73 |
Lymphocytes, median (IQR) | 1.5 (1.26–2.1) | 1.5 (1.2–1.9) | 0.62 |
Platelets, median (IQR) | 223 (189–271) | 241 (192–296) | 0.48 |
CRP, median (IQR) | 3 (2.9–5) | 3 (2–4) | 0.77 |
Albumin, median (IQR) | 4.2 (4–4.4) | 4.2 (4.1–4.4) | 0.93 |
PNI ≥ 42.05, n% | 4 (7.55%) | 4 (13.33%) | 0.31 |
NLR ≥ 2.38, n% | 26 (49.86%) | 16 (53.33%) | 0.44 |
PLR ≥ 185.5 n % | 13 (24.53%) | 13 (43.33%) | 0.06 |
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Serafini, S.; Friziero, A.; Sperti, C.; Vallese, L.; Grego, A.; Piangerelli, A.; Belluzzi, A.; Moletta, L. The Ratio of C-Reactive Protein to Albumin Is an Independent Predictor of Malignant Intraductal Papillary Mucinous Neoplasms of the Pancreas. J. Clin. Med. 2021, 10, 2058. https://doi.org/10.3390/jcm10102058
Serafini S, Friziero A, Sperti C, Vallese L, Grego A, Piangerelli A, Belluzzi A, Moletta L. The Ratio of C-Reactive Protein to Albumin Is an Independent Predictor of Malignant Intraductal Papillary Mucinous Neoplasms of the Pancreas. Journal of Clinical Medicine. 2021; 10(10):2058. https://doi.org/10.3390/jcm10102058
Chicago/Turabian StyleSerafini, Simone, Alberto Friziero, Cosimo Sperti, Lorenzo Vallese, Andrea Grego, Alfredo Piangerelli, Amanda Belluzzi, and Lucia Moletta. 2021. "The Ratio of C-Reactive Protein to Albumin Is an Independent Predictor of Malignant Intraductal Papillary Mucinous Neoplasms of the Pancreas" Journal of Clinical Medicine 10, no. 10: 2058. https://doi.org/10.3390/jcm10102058