Jiang D, Chen ZX, Ma FX, Gong YY, Pu T, Chen JM, Liu XQ, Zhao YJ, Xie K, Hou H, Wang C, Geng XP, Liu FB. Online calculator for predicting the risk of malignancy in patients with pancreatic cystic neoplasms: A multicenter, retrospective study. World J Gastroenterol 2022; 28(37): 5469-5482 [PMID: 36312834 DOI: 10.3748/wjg.v28.i37.5469]
Corresponding Author of This Article
Fu-Bao Liu, MD, PhD, Chief Doctor, Professor, Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, No. 81 Meishan Road, Hefei 230000, Anhui Province, China. lancetlfb@126.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dong Jiang, Zi-Xiang Chen, Fu-Xiao Ma, Yu-Yong Gong, Tian Pu, Jiang-Ming Chen, Xue-Qian Liu, Yi-Jun Zhao, Kun Xie, Xiao-Ping Geng, Fu-Bao Liu, Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230000, Anhui Province, China
Hui Hou, Department of General Surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei 230000, Anhui Province, China
Cheng Wang, Department of General Surgery, The First Affiliated Hospital of University of Science and Technology of China, Hefei 230000, Anhui Province, China
Author contributions: Jiang D, Chen JM, Chen ZX and Ma FX contributed to the data analysis and participated in drafting the article; Liu XQ, Gong YY, and Pu T extracted the clinical data and calculated the clinical correlations; Xie K and Zhao YJ interpreted the results and revised the manuscript; Liu FB, Hou H, Wang C and Geng XP gave final approval of the version to be published; All authors contributed to the design and interpretation of the study and to further drafts and approved the final version to be published.
Supported byUniversity Natural Science Research Project of Anhui Province, No. KJ2021ZD0021.
Institutional review board statement: The study was reviewed and approved by the Institutional ethics committees of the First Affiliated Hospital of Anhui Medical University (Approval Quick-PJ2022-06-26).
Informed consent statement: All study participants or their legal guardian provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fu-Bao Liu, MD, PhD, Chief Doctor, Professor, Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, No. 81 Meishan Road, Hefei 230000, Anhui Province, China. lancetlfb@126.com
Received: June 16, 2022 Peer-review started: June 16, 2022 First decision: July 12, 2022 Revised: July 25, 2022 Accepted: September 8, 2022 Article in press: September 8, 2022 Published online: October 7, 2022 Processing time: 105 Days and 7.7 Hours
ARTICLE HIGHLIGHTS
Research background
Efficient and practical methods for predicting the risk of malignancy in patients with pancreatic cystic neoplasms (PCNs) are currently lacking.
Research motivation
Currently, there is no effective clinical prediction model for patients with PCNs and no large study has been conducted to predict malignant risk.
Research objectives
The aim of this study was to identify the risk factors influencing the malignant risk of PCNs and develop a prediction model that is useful for clinical surgeons when making decisions regarding surgical interventions.
Research methods
Data collected in three major medical centers were analyzed to identify independent risk parameters and propose a calculator for patients with PCNs. A number of statistical indices, such as concordance index, calibration curves, area under the curve, decision curve analysis, CIC and others were used to evaluate the performance of the nomogram.
Research results
Five factors, including enhanced mural nodules, tumor diameter ≥ 40 mm, main pancreatic duct dilatation, preoperative neutrophil-to-lymphocyte ratio ≥ 2.288 and preoperative serum CA19-9 concentration ≥ 34 U/mL were found to independently influencing the risk of malignancy. As a result, the model we constructed has a greater predictive value than the factors identified in relevant guidelines.
Research conclusions
For the first time, a model was developed to predict the malignant risk of PCNs and an online calculator was further established to guide decision-making.
Research perspectives
More medical centers included, more data collection and application of “Artificial Intelligence”.
