Background
Hepatobiliary mucinous cystic neoplasms (H-MCNs) are quite rare cystic neoplasms in the liver. The management and prognosis between the hepatic simple cyst (HSC) and H-MCNs are adverse, and the differential diagnosis of H-MCNs remains big challenging. This study aimed to present our experience in the management of H-MCNs and provide a preoperative H-MCNs risk prediction nomogram to differentiating H-MCNs from HSC.
Methods
29 patients diagnosed with H-MCNs and 75 patients diagnosed with HSC between June 2011 and June 2019 at Zhejiang University, School of medicine, Sir Run-Run Shaw Hospital, were reviewed in this study. Demographic and clinicopathological variables were analyzed.
Results
US, CT, and MRI could accurately diagnose only 3.4%, 46.1%, and 57.1% of H-MCNs, respectively. After univariate analysis and multivariate logistic regression analysis, the variables significantly associated with H-MCNs were enhancement after contrast (p = 0.009), tumour located in the left lobe (p = 0.02) and biliary ductal dilation (p = 0.027). An H-MCN risk predictive nomogram constructed by these factors and serum CA199 level showed excellent discrimination (areas under the receiver operating characteristic curve were 0.940) and agreement calibration between predicted probability and actual probability.
Conclusion
Among patients with the H-MCNs, the location of the tumour, enhancement in CT scan, and biliary ductal dilation are significantly independent risk factors. The reasonable treatment of H-MCNs is radical resection. Using our nomogram could facilitate screening and identification of patients with liver cystic lesions.