@article{Lan2018, 
author = {Chungen Lan and Xin Li and Xiuchao Wang and Jihui Hao and He Ren},
title = {A new combined criterion to better predict malignant lesions in patients with pancreatic cystic neoplasms},
year = {2018},
journal = {Cancer Biology & Medicine},
volume = {15},
number = {1},
pages = {70-78},
keywords = {Malignant pancreatic cystic neoplasm, neutrophil-lymphocyte ratio, enhanced solid component, combined criterion, diagnosis},
url = {https://www.sciopen.com/article/10.20892/j.issn.2095-3941.2017.0152},
doi = {10.20892/j.issn.2095-3941.2017.0152},
abstract = {ObjectiveCystic lesions of the pancreas have been increasingly recognized. Some lesions exhibit benign behavior, while others have unequivocal malignant potential. Thus, accurate identification of malignancy in patients diagnosed with pancreatic cystic neoplasms (PCNs) remains a major challenge. The aim of this study was to define a combined criterion to better predict malignant lesions in patients with PCNs.MethodsWe retrospectively analyzed 165 patients who underwent resection of PCNs from October 2011 to May 2017. The relationship among malignancy and serum carbohydrate antigen 19-9 (CA19-9), preoperative neutrophil-to-lymphocyte ratio (NLR), and the presence of enhanced solid component on imaging was analyzed.ResultsNLR before surgery in patients with malignant PCNs (2.81±2.14) was significantly higher than that in patients diagnosed with pancreatic neuroendocrine tumor (1.90±0.69, P=0.013) or healthy volunteers (1.40±0.48; P<0.001). Serum CA19-9 ≥39 U/mL, NLR >1.976 and presence of enhanced solid component were independent predictors of PCN malignancy. A combined criterion meeting any two or more of the three elements including CA19-9 ≥39 U/mL, NLR >1.976, and presence of enhanced solid component on computed tomography imaging is an indicator with a high positive predictive value of 80.5% and a high negative predictive value of 87.9%, and thus, represents a highly accurate test (86.1%).ConclusionsThe new combined criterion is an effective predictor of tumor malignancy in patients with PCNs.}
}