PT  - JOURNAL ARTICLE
AU  - Chungen Lan
AU  - Xin Li
AU  - Xiuchao Wang
AU  - Jihui Hao
AU  - He Ren
TI  - A new combined criterion to better predict malignant lesions in patients with pancreatic cystic neoplasms
AID  - 10.20892/j.issn.2095-3941.2017.0152
DP  - 2018 Feb 01
TA  - Cancer Biology and Medicine
PG  - 70--78
VI  - 15
IP  - 1
4099  - http://www.cancerbiomed.org/content/15/1/70.short
4100  - http://www.cancerbiomed.org/content/15/1/70.full
SO  - Cancer Biol Med2018 Feb 01; 15
AB  - Objective: Cystic lesions of the pancreas have been increasingly recognized. Some lesions exhibit benign behavior, while others have unequivocal malignant potential. Thus, accurate identification of malignancy in patients diagnosed with pancreatic cystic neoplasms (PCNs) remains a major challenge. The aim of this study was to define a combined criterion to better predict malignant lesions in patients with PCNs.Methods: We retrospectively analyzed 165 patients who underwent resection of PCNs from October 2011 to May 2017. The relationship among malignancy and serum carbohydrate antigen 19-9 (CA19-9), preoperative neutrophil-to-lymphocyte ratio (NLR), and the presence of enhanced solid component on imaging was analyzed.Results: NLR before surgery in patients with malignant PCNs (2.81±2.14) was significantly higher than that in patients diagnosed with pancreatic neuroendocrine tumor (1.90±0.69, P=0.013) or healthy volunteers (1.40±0.48; P<0.001). Serum CA19-9 ≥39 U/mL, NLR >1.976 and presence of enhanced solid component were independent predictors of PCN malignancy. A combined criterion meeting any two or more of the three elements including CA19-9 ≥39 U/mL, NLR >1.976, and presence of enhanced solid component on computed tomography imaging is an indicator with a high positive predictive value of 80.5% and a high negative predictive value of 87.9%, and thus, represents a highly accurate test (86.1%).Conclusions: The new combined criterion is an effective predictor of tumor malignancy in patients with PCNs.