タカヤマ　ユキコ   TAKAYAMA Yukiko   高山　敬子    所属   医学部 医学科（東京女子医科大学病院）    職種   講師
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	Prospective multicenter surveillance study of branch-duct intraductal papillary mucinous neoplasm of the pancreas; risk of dual carcinogenesis
掲載誌名	正式名：Pancreatology 略　 称：Pancreatology ISSNコード：14243911/14243903
掲載区分	国外
巻・号・頁	24(7),pp.1141-1151
著者・共著者	OHTSUKA Takao, MAGUCHI Hiroyuki, TOKUNAGA Shoji, HIJIOKA Susumu, TAKAYAMA Yukiko, KOSHITA Shinsuke, NAHADA Keiji, SUDO Kentaro, UEHARA Hiroyuki, TANNO Satoshi, TADA Minoru, KIMURA Wataru, NAKAMURA Masafumi, KIN Toshifumi, KAMATA Ken, MASAMUNE Atsushi, IWASHITA Takuji, AKAHOSHI Kazuya, UEKI Toshiharu, OKAMURA Keiya, KATO Hironari, KUMAGI Teru, KAWABE Ken, YOSHIDA Koji, MUKAI Tsuyoshi, SAKAGAMI Junichi, HIRONO Seiko, ABUE Makoto, NAKAFUSA Tomoki, MORITA Makiko, SHIMOSEGAWA Toru, TANAKA Masao
発行年月	2024/11
概要	BACKGROUND:The natural history of branch-duct intraductal papillary mucinous cystic neoplasms (BD-IPMNs) in the pancreas remains unclear. This study aimed to answer this clinical question by focusing on the development of concomitant pancreatic ductal adenocarcinomas (cPDAC).METHODS:The Japan Pancreas Society conducted a prospective multicenter surveillance study of BD-IPMN every six months for five years. The primary endpoints were progression of BD-IPMN, progression to high-grade dysplasia/invasive carcinoma (HGD/IC), and cPDAC. Factors predicting the progression of BD-IPMN to HGD/IC and development of cPDAC were also assessed as secondary endpoints.RESULTS:Among the 2104 non-operated patients, 348 (16.5 %) showed progression of primary BD-IPMN. Cumulative incidences of BD-IPMN with HGD/IC and cPDAC during the 5.17-year surveillance period were 1.90 % and 2.11 %, respectively, and standard incidence ratios of BD-IPMN with HGD/IC and cPDAC were 5.28 and 5.73, respectively. Of 38 cPDACs diagnosed during surveillance, 25 (65.8 %) were resectable. The significant predictive characteristics of BD-IPMN for progression to HGD/IC were larger cyst size (p = 0.03), larger main pancreatic duct size (p < 0.01), and mural nodules (p = 0.02). Significant predictive characteristics for the development of cPDAC were male sex (p = 0.03) and older age (p = 0.02), while the size of IPMN was not significant.CONCLUSION:Careful attention should be given to "dual carcinogenesis" during BD-IPMN surveillance, indicating the progression of BD-IPMN to HGD/IC and development of cPDAC distinct from BD-IPMN, although the establishment of risk factors that predict cPDAC development remains a challenge (UMIN000007349).
DOI	10.1016/j.pan.2024.08.013
PMID	39191596