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ナカイ ヨウスケ
NAKAI Yousuke
中井 陽介 所属 医学部 医学科（東京女子医科大学病院） 職種 教授・基幹分野長 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Risk factors for pancreatic cancer in individuals with intraductal papillary mucinous neoplasms and no high-risk stigmata during up to 5 years of surveillance: a prospective longitudinal cohort study. |
| 掲載誌名 | 正式名：Gut 略 称：Gut ISSNコード：14683288/00175749 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 74(6),pp.971-982 |
| 著者・共著者 | HAMADA Tsuyoshi,OYAMA Hiroki, Daniel Nevo,TANGE Shuichi,TAKAOKA Shinya,KAWAGUCHI Yoshikuni,ISHIGAKI Kazunaga,NOGUCHI Kensaku,SAITO Tomotaka,SATO Tatsuya,SUZUKI Tatsunori,TAKEHARA Naminatsu,TANAKA Mariko,HASEGAWA Kiyoshi,USHIKU Tetsuo,NAKAI Yosuke, Maxim S Petrov,FUJISHIRO Mitsuhiro |
| 発行年月 | 2025/05 |
| 概要 | BACKGROUND:Cyst size, its growth rate, and diameter of the main pancreatic duct (MPD) are all associated with pancreatic carcinoma prevalence in intraductal papillary mucinous neoplasms (IPMNs).OBJECTIVE:To examine the above factors in relation to future risk of incident pancreatic carcinoma in individuals with IPMNs harbouring no high-risk stigmata.DESIGN:In a prospective longitudinal cohort, we analysed 2549 patients with IPMNs. A multivariable cause-specific Cox proportional hazards regression model was built to estimate HRs for incident pancreatic carcinoma.RESULTS:IPMN size at baseline and its annual growth rate over 2 years of follow-up were associated with incident pancreatic carcinoma (ptrend<0.001). The multivariable cause-specific HR per 10 mm increase in IPMN size was 1.28 (95% CI 1.10 to 1.50). The annual growth rates of 1.5-2.4 mm/year and ≥2.5 mm/year over 2 years were associated with multivariable cause-specific HRs of 1.91 (95% CI 0.78 to 4.67) and 4.52 (95% CI 2.28 to 8.98), respectively (vs <1.5 mm/year). Neither IPMN size at 5 years nor its maximum growth rate during 5 years was associated with incident pancreatic carcinoma (ptrend>0.07). MPD diameter at 5 years was associated with incident pancreatic carcinoma (multivariable cause-specific HR per 2 mm increase, 2.12; 95% CI 1.72 to 2.63). A predictive nomogram was generated for calculating the risk of incident pancreatic carcinoma.CONCLUSION:IPMN size and its growth rate predict future pancreatic carcinoma risk only during first 5 years of follow-up. MPD diameter at 5 years may identify patients who still harbour a high risk for pancreatic carcinoma. |
| DOI | 10.1136/gutjnl-2024-333259 |
| PMID | 39870394 |