Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 7, 2022; 28(37): 5469-5482
Published online Oct 7, 2022. doi: 10.3748/wjg.v28.i37.5469
Online calculator for predicting the risk of malignancy in patients with pancreatic cystic neoplasms: A multicenter, retrospective study
Dong Jiang, Zi-Xiang Chen, Fu-Xiao Ma, Yu-Yong Gong, Tian Pu, Jiang-Ming Chen, Xue-Qian Liu, Yi-Jun Zhao, Kun Xie, Hui Hou, Cheng Wang, Xiao-Ping Geng, Fu-Bao Liu
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 by University 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”.