Follow up of Branch Duct Intraductal Papillary Mucinous Neoplasms (BD-IPMN) of the pancreas with a cyst over 30mm in diameter: A single center experience

Abstract

s / Pancreatology Aims: The aim of our study was to examine independent factors (gender, presence of chronic pancreatitis, anatomic localization, mucin expression) as potential risk factors for malignant IPMTs. Patients & methods: 48 patients underwent surgical resection were proved to have IPMT between the period of 2002-2013. Samples were grouped according to type of the tumour as main duct-(MD), branch duct(BD) or mixed-type (MX) IPMTs. We created subgroups based on the malignant behaviour and the mucin expression profile, like intestinal (I), pancreatobiliary (PB) and gastric-type (G) IPMTs. We examined the presence of chronic pancreatitis and the correlation with the presence of malignant IPMTs. Results: 12 BD-,15MDand 21MXtype IPMTswere found.16,7% of the patients had low-gradeand 33,3% had high-grade dysplasia. Based on the mucin expression profile 14,2% of the G-, 37,5% of the Iand 75% of the PBtype IPMTs were found to be malignant. 79,2% of the malignant IPMTs, were localized in the head of the pancreas. 33,3% of the patients without chronic pancreatitis, while 66,7% of the patients with chronic pancreatitis had malignant IPMT. Conclusion: The presence of chronic pancreatitis may have an important role to increase the malignant behaviour of the IPMTs. Lack of MUC1 expression may be related to less invasive characteristics of IPMTs. MUC2+ alone, or MUC1+ and MUC5AC+ expression together can predict the malignant potential of IPMTs.