Should Contrast-Enhanced Harmonic Endoscopic Ultrasound Be Incorporated into the International Consensus Guidelines to Determine the Appropriate Treatment of Intraductal Papillary Mucinous Neoplasm?
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients
2.2. FB-EUS and CH-EUS
2.3. Pathological Investigations
2.4. Outcome Definitions
2.5. Statistical Analysis
3. Results
3.1. Baseline Characteristics
3.2. Investigation of Whether the Incorporation of CH-EUS into the 2017 ICG Could Improve the Malignancy Diagnostic Value of IPMN
3.3. Examination of the Usefulness of CH-EUS for Predicting Malignant IPMN
4. Discussion
Why Is CH-EUS Not Adopted in ICG?
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Total (n = 109) | |
---|---|
Sex (male:female), n | 53:56 |
Age, mean (range), years | 69.5 (41–86) |
Morphology | |
Cyst size, median (range), mm | 28.1 (3–62) |
Diameter of MPD, median (range), mm | 5.7 (0.8–25) |
Height of nodule *, median (range), mm | 9.0 (1–52) |
Cyst location, n | |
Head | 69 |
Body/tail | 40 |
IPMN type (macro classification), n | |
BD-type | 61 |
Mixed-type | 48 |
Pathology, n | |
LGD | 52 |
HGD | 25 |
Invasive carcinoma | 32 |
2017 ICG | CH-EUS Incorporation ICG | p-Value | |
---|---|---|---|
Sensitivty | 78.9% (45/57) | 78.9% (45/57) | 1.00 |
Specificity | 42.3% (22/52) | 53.8% (28/52) | 0.33 |
PPV | 60.0% (45/75) | 65.2% (45/69) | 0.61 |
NPV | 64.7% (22/34) | 70.0% (28/40) | 0.80 |
Predictor | Univariate Analysis | Multivariate Analysis | ||||
---|---|---|---|---|---|---|
OR | 95%CI | p-Value | OR | 95%CI | p-Value | |
CA19-9 | 1.01 | 0.99–1.02 | 0.46 | |||
Total bilirubin | 1.48 | 0.35–6.32 | 0.59 | |||
Diameter of MPD | 1.07 | 0.92–1.24 | 0.38 | 1.13 | 0.99–1.28 | 0.063 |
Size of IPMN | 0.99 | 0.95–1.02 | 0.50 | |||
Height of nodule measured by CE-CT | 1.06 | 0.90–1.25 | 0.47 | |||
Height of nodule measured by FB-EUS | 0.90 | 0.78–1.04 | 0.15 | 0.91 | 0.80–1.02 | 0.12 |
Height of nodule measured by CH-EUS | 1.30 | 1.08–1.55 | <0.01 | 1.28 | 1.10–1.49 | <0.01 |
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Yamazaki, T.; Takenaka, M.; Omoto, S.; Yoshikawa, T.; Ishikawa, R.; Okamoto, A.; Nakai, A.; Minaga, K.; Kamata, K.; Yamao, K.; et al. Should Contrast-Enhanced Harmonic Endoscopic Ultrasound Be Incorporated into the International Consensus Guidelines to Determine the Appropriate Treatment of Intraductal Papillary Mucinous Neoplasm? J. Clin. Med. 2021, 10, 1818. https://doi.org/10.3390/jcm10091818
Yamazaki T, Takenaka M, Omoto S, Yoshikawa T, Ishikawa R, Okamoto A, Nakai A, Minaga K, Kamata K, Yamao K, et al. Should Contrast-Enhanced Harmonic Endoscopic Ultrasound Be Incorporated into the International Consensus Guidelines to Determine the Appropriate Treatment of Intraductal Papillary Mucinous Neoplasm? Journal of Clinical Medicine. 2021; 10(9):1818. https://doi.org/10.3390/jcm10091818
Chicago/Turabian StyleYamazaki, Tomohiro, Mamoru Takenaka, Shunsuke Omoto, Tomoe Yoshikawa, Rei Ishikawa, Ayana Okamoto, Atsushi Nakai, Kosuke Minaga, Ken Kamata, Kentaro Yamao, and et al. 2021. "Should Contrast-Enhanced Harmonic Endoscopic Ultrasound Be Incorporated into the International Consensus Guidelines to Determine the Appropriate Treatment of Intraductal Papillary Mucinous Neoplasm?" Journal of Clinical Medicine 10, no. 9: 1818. https://doi.org/10.3390/jcm10091818