ArticleAnnals of surgery2018
Multi-institutional Validation Study of Pancreatic Cyst Fluid Protein Analysis for Prediction of High-risk Intraductal Papillary Mucinous Neoplasms of the Pancreas.
Article in Annals of surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 45 citations in OpenAlex.
- Can we better predict the biologic behavior of incidental IPMN? A comprehensive analysis of molecular diagnostics and biomarkers in intraductal papillary mucinous neoplasms of the pancreas.Langenbeck's archives of surgery · 2018Pooled it
- Cancer Risk After Initial Surveillance of Intraductal Papillary Mucinous Neoplasms (IPMNs): Are We Missing the Window for Prevention?Annals of surgical oncology · 2026Article
- Imaging-Based Risk Stratification of IPMN Using a Structured Imaging Score: A Retrospective Proof-of-Concept Study.Current oncology (Toronto, Ont.) · 2026Article
- Gut Microbiota-Brain Axis in Pancreatic Cystic Neoplasms: An Observational Analysis.Pakistan journal of medical sciences · 2025Article
- ACSS2/AATF Drives Soluble FasL-Mediated CD8Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Article
- An Overview for Clinicians on Intraductal Papillary Mucinous Neoplasms (IPMNs) of the Pancreas.Cancers · 2024Review
- Digital spatial profiling of intraductal papillary mucinous neoplasms: Toward a molecular framework for risk stratification.Science advances · 2023Article
- Circulating cytokines allow for identification of malignant intraductal papillary mucinous neoplasms of the pancreas.Cancer medicine · 2023Article
- Surgical treatment for pancreatic cystic lesions-implications from the multi-center and prospective German StuDoQ|Pancreas registry.Langenbeck's archives of surgery · 2023Article
- ASO Author Reflections: Spatial Immunophenotyping of Intraductal Papillary Mucinous Neoplasm.Annals of surgical oncology · 2022Article
- Perioperative risk of pancreatic head resection-nomogram-based prediction of severe postoperative complications as a decisional aid for clinical practice.Langenbeck's archives of surgery · 2022Article
- Risk stratification tools for branch-duct intraductal papillary mucinous neoplasms of the pancreas.United European gastroenterology journal · 2022Article
- Biomarkers in the diagnosis of pancreatic cancer: Are we closer to finding the golden ticket?World journal of gastroenterology · 2021Review
- Narrative review of intraductal papillary mucinous neoplasms: pathogenesis, diagnosis, and treatment of a true precancerous lesion.Gland surgery · 2021Review
- Radiomics for the Diagnosis and Differentiation of Pancreatic Cystic Lesions.Diagnostics (Basel, Switzerland) · 2020Review
- Molecular Diagnosis of Cystic Neoplasms of the Pancreas: a Review.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2020Review
- Multimodal radiomics and cyst fluid inflammatory markers model to predict preoperative risk in intraductal papillary mucinous neoplasms.Journal of medical imaging (Bellingham, Wash.) · 2020Article
- Molecular Diagnostics and Testing for Pancreatic Cysts.Current treatment options in gastroenterology · 2020Review
- Stratifying Intraductal Papillary Mucinous Neoplasms by Cyst Fluid Analysis: Present and Future.International journal of molecular sciences · 2020Review
- Development of a stratification tool to identify pancreatic intraductal papillary mucinous neoplasms at lowest risk of progression.Alimentary pharmacology & therapeutics · 2019Article
Corrections and comments
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Authors and funding
22 authors at 5 institutions in 1 country.
Funding
Abstract
objectivePreliminary work by our group suggested that proteins within the pancreatic cyst fluid (CF) may discriminate degree of IPMN dysplasia. We sought to externally validate these markers and determine whether their inclusion in a preoperative clinical nomogram could increase diagnostic accuracy. SUMMARY BACKGROUND DATA: IPMN is the most common radiographically identifiable precursor to pancreatic cancer; however, the timing and frequency of its malignant progression are unknown, and there are currently no reliable preoperative tests that can determine the grade of dysplasia in IPMN.
methodsClinical and radiographic data, as well as CF samples, were obtained from 149 patients who underwent resection for IPMN at 1 of 3 institutions. High-risk disease was defined as the presence of high-grade dysplasia or invasive carcinoma. Multianalyte bead array analysis (Luminex) of CF was performed for 4 protein markers that were previously associated with high-risk disease. Logistic regression models were fit on training data, with and without adjustment for a previously developed clinical nomogram and validated with an external testing set. The models incorporating clinical risk score were presented graphically as nomograms.
resultsWithin the group of 149 resected patients, 89 (60%) had low-risk disease, and 60 (40%) had high-risk disease. All 4 CF markers (MMP9, CA72-4, sFASL, and IL-4) were overexpressed in patients with high-risk IPMN (P < 0.05). Two predictive models based on preselected combinations of CF markers had concordance indices of 0.76 (Model-1) and 0.80 (Model-2). Integration of each CF marker model into a previously described clinical nomogram leads to increased discrimination compared with either the CF models or nomogram alone (c-indices of 0.84 and 0.83, respectively).
conclusionsThis multi-institutional study validated 2 CF protein marker models for preoperative identification of high-risk IPMN. When combined with a clinical nomogram, the ability to predict high-grade dysplasia was even stronger.
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