Endoscopy 2019; 51(04): S43
DOI: 10.1055/s-0039-1681296
ESGE Days 2019 oral presentations
Friday, April 5, 2019 11:00 – 13:00: EUS diagnosis pancreas Club D
Georg Thieme Verlag KG Stuttgart · New York

RISK SCORE FOR EARLY PREDICTION OF INVASIVE CANCER OF BD-IPMNACCORDING TO MORPHOLOGICAL CHARACTERIZATION IN EUS IN PATIENTS WHO UNDERWENT TO PANCREATIC SURGERY

L Uribarri Gonzalez
1   Complejo Hospitalario de Navarra, Digestive System Service, Endoscopy Unit, Pamplona, Spain
,
E Perez-Cuadrado Robles
2   Cliniques Universitaires Saint-Luc, Endoscopy Unit, Brussels, Belgium
,
S López López
1   Complejo Hospitalario de Navarra, Digestive System Service, Endoscopy Unit, Pamplona, Spain
,
J Lariño Noia
3   Hospital Universitario Santiago de Compostela, Endoscopy Unit, Santiago de Compostela, Spain
,
E Martinez Moneo
4   Hospital Universitario Cruces, Bilbao, Spain
,
J Iglesias Garcia
3   Hospital Universitario Santiago de Compostela, Endoscopy Unit, Santiago de Compostela, Spain
,
I Fernandez-Urien Sanz
1   Complejo Hospitalario de Navarra, Digestive System Service, Endoscopy Unit, Pamplona, Spain
,
J Carrascosa Gil
1   Complejo Hospitalario de Navarra, Digestive System Service, Endoscopy Unit, Pamplona, Spain
,
PH Deprez
2   Cliniques Universitaires Saint-Luc, Endoscopy Unit, Brussels, Belgium
,
J Vila Costas
1   Complejo Hospitalario de Navarra, Digestive System Service, Endoscopy Unit, Pamplona, Spain
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 
 

    Aims:

    To develop a risk score for early prediction of invasive cancer of BD-IPMN according to morphological characterization in EUS, using the surgical specimens as gold standard.

    Methods:

    Retrospective multicenter observational study in patients with BD-IPMN who underwent EUS and a surgical treatment between 2005 and 2017. Morphological features by EUS were evaluated. A score using a logistic regression model was performed to assess the risk of invasive cancer.

    Results:

    One-hundred and thirty-one patients (50% men, mean age: 66 ± 11 years) were included. The presentation was incidental in 40% of cases and contrast enhancement was performed in 34.6%. The low-intermediate grade dysplasia, high grade dysplasia and invasive cancer rates were and 51.9%, 24.4% and 23.7% respectively.

    Size≥30 mm (p = 0.011), enhancing nodules (p < 0.001), pancreatic duct ≥10 mm (p < 0.001), lymph nodes (p < 0.001) and abrupt change (p < 0.001) were associated with cancer in univariable analysis. By multivariable analysis, lymph nodes [OR: 16.612 (CI95%:2.554 – 108.058), p = 0.003, 4 score points], pancreatic duct ≥10 mm [OR: 8.220 (CI95%:1.774 – 38.087), p = 0.007, 2 score points], abrupt change [OR: 5.890 (CI95%:1.417 – 24.482), p = 0.015, 1.5 score point], and enhancing nodules [OR: 4.276 (CI95%:1.303 – 14.032), p = 0.017, 1 score point], were independent factors associated with invasive cancer. The Nagelkerke index of the model was 0.539. The Area under the curve was 0.857 (p < 0.001) with a sensitivity and specificity of 84% and 70% respectively in an internal validation of the model. The following categories of the score (0 – 8.5points): A (0 – 1), B (1.5 – 3), C (3.5 – 5), D (5.5 – 8.5 points) presented a positive predictive value of 8.5%, 42.1%, 57.1% and 100% rates of invasive cancer.

    Conclusions:

    This EUS predictive score estimates the risk of invasive cancer in patients with BD-IPMN with a high accuracy.


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