Risk Factors for Intraductal Papillary Mucinous Neoplasm (IPMN) of the Pancreas: A Multicentre Case–Control Study

Capurso, Gabriele; Boccia, Stefania; Salvia, Roberto; Chiaro, Marco Del; Frulloni, Luca; Arcidiacono, Paolo Giorgio; Zerbi, Alessandro; Manta, Raffaele; Fabbri, Carlo; Ventrucci, Maurizio; Tarantino, Ilaria; Piciucchi, Matteo; Carnuccio, Antonella; Boggi, Ugo; Leoncini, Emanuele; Costamagna, Guido; Fave, Gianfranco Delle; Pezzilli, Raffaele; Bassi, Claudio; Larghi, Alberto

doi:10.1038/ajg.2013.42

Cited by 113 publications

(79 citation statements)

References 32 publications

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“…It has been described that previous history of diabetes, especially with insulin dependency, chronic pancreatitis, or a familial history of pancreatic ductal adenocarcinoma (PDAC), may haveahigherriskforIPMN [25]. Also, several studies have noticed that the presence of autoimmune disease in general population is around 5%; however, in patients diagnosed with IPMN, the number rises up to 22%.…”

Section: Risk Factorsmentioning

confidence: 94%

Intraductal Papillary Mucinous Neoplasms of the Pancreas: Challenges and New Insights

Carroll¹,

Reyes²,

Vázquez³

2017

Challenges in Pancreatic Pathology

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Cystic lesions of the pancreas are a common entity with almost a 25% incidence of the general population. These types of lesions are being increasingly diagnosed partly explained due to the technological advances over the past years. The management and treatment varies per cyst type. However, the most threatening cyst lesions are intraductal papillary mucinous neoplasms (IPMNs). These lesions represent nowadays a relatively new clinical entity and in many aspects remain poorly understood. The aim of this chapteristoprovideacomprehensivereviewoftheclassification,diagnosis,treatment and follow-up strategy.

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Section: Risk Factorsmentioning

confidence: 94%

Intraductal Papillary Mucinous Neoplasms of the Pancreas: Challenges and New Insights

Carroll¹,

Reyes²,

Vázquez³

2017

Challenges in Pancreatic Pathology

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“…Capurso et al [10] compared 390 patients with IPMN with 390 matched controls and found that a history of DM, CP, and a family history of pancreatic cancer were all independent risk factors for IPMN. Carr et al [11] examined the association between IPMN malignant progression and smoking in 324 resected IPMNs and found no significant difference in the percentage of invasive IPMNs between smokers and nonsmokers (22 vs. 18%, p = 0.5).…”

Section: Discussionmentioning

confidence: 99%

“…Several studies investigated the association of environmental, personal, and hereditary risk factors with the occurrence or degree of IPMN [10][11][12][13][14] . Capurso et al [10] compared 390 patients with IPMN with 390 matched controls and found that a history of DM, CP, and a family history of pancreatic cancer were all independent risk factors for IPMN.…”

Section: Discussionmentioning

confidence: 99%

Association between the Risk Factors for Pancreatic Ductal Adenocarcinoma and Those for Malignant Intraductal Papillary Mucinous Neoplasm

Kamata¹,

Takenaka²,

Nakai³

et al. 2017

Oncology

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Background and Aims: Risk factors for pancreatic ductal adenocarcinoma (PDAC) include diabetes mellitus, chronic pancreatitis, obesity, a family history of pancreatic cancer, and a history of smoking or alcohol consumption. The aim of this study was to evaluate the association between risk factors for PDAC and malignant intraductal papillary mucinous neoplasm (IPMN). Methods: The study included 134 consecutive patients with IPMN who underwent surgical resection at Kindai University Hospital between April 2009 and March 2015. Data on the presence or absence of mural nodules (MNs) and risk factors for PDAC were evaluated. Multivariable logistic regression analysis was performed with malignant IPMN as the outcome variable and MNs and risk factors for PDAC as explanatory variables. Results: The odds ratio of malignant IPMN to MNs was 3.88 (95% confidence interval [CI] 1.53-9.84; p = 0.004), whereas that of malignant IPMN to smoking history was 1.66 (95% CI 0.74-3.71; p = 0.22). When the presence of MNs was considered as a predictive factor for malignancy, the sensitivity and specificity were 88.5 and 32.1%, respectively, whereas when the presence of both smoking history and MNs was considered, the specificity improved to 73.2%, with a decrease in sensitivity to 42.3%. Conclusions: The presence of both a smoking history and MNs was a valuable predictive factor for malignant IPMN with high specificity. A smoking history should be considered before surgical resection in addition to the presence of MNs.

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“…Controls were patients seen at the same units' gastrointestinal outpatient clinics during the same time period, for evaluation of different gastrointestinal disorders, with willingness and ability to participate, as previously described [14,25]. We used a frequency matching (oversampling controls with a 4:1 rate) in which every time a case was enrolled and interviewed, the first four eligible controls of the same sex and age (±5 years) were enrolled.…”

Section: Methodsmentioning

confidence: 99%

“…The amount of smoking was evaluated as pack-years (pack-year = number of packs per day × years of smoking). A cut-off of 20 pack-years was set to define heavy smokers [14,25,26]. …”

Section: Methodsmentioning

confidence: 99%

Risk and Protective Factors for Small Intestine Neuroendocrine Tumors: A Prospective Case-Control Study

et al. 2015

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Background: The incidence of small intestine neuroendocrine tumors (SI-NETs) is increasing, but few studies have investigated risk factors for their occurrence, suggesting that family history (FH) of any cancer, smoking and previous cholecystectomy are associated with an increased risk. Such studies investigated small series or examined cancer registries without direct interviews. Aim: We therefore aimed at clarifying risk and protective factors for the occurrence of sporadic SI-NETs. Subjects and Methods: We performed a multicenter case-control study. Patients with a histologic diagnosis of SI-NETs were prospectively evaluated, excluding familial syndromes. Controls with non-neoplastic/non-chronic disorders seen at gastrointestinal outpatients clinics were matched for sex and age (4:1). All subjects were directly interviewed by means of a specific questionnaire on potential risk and protective factors. Cases and controls were compared by Fisher's test or Student's t test for categorical or continuous variables. Explanatory variables were analyzed by simple logistic regression analysis. A multiple logistic regression analysis was performed with an Enter model; p < 0.05 was considered significant. Results: 215 SI-NET patients and 860 controls were enrolled. FH of colorectal cancer (CRC) (8.8 vs. 5.0%) and breast cancer (10.2 vs. 4.8%), heavy smoking (24.7 vs. 14.8%) and drinking >21 alcohol units per week (7.4 vs. 3.8%) were all significantly more frequent in SI-NET patients than in controls. Multivariate analysis showed that FH of CRC (OR 2.23, 95% CI 1.29-3.84, p = 0.003), FH of breast cancer (OR 2.05, 95% CI 1.13-3.69, p = 0.01) and smoking (OR 1.47, 95% CI 1.07-2.03, p = 0.01) and in particular heavy smoking (OR 1.94, 95% CI 1.29-3.84, p = 0.0008) were associated with an increased risk for carcinoid occurrence, while use of aspirin can be considered a protective factor (OR 0.20, 95% CI 0.06-0.65, p = 0.008). Conclusion: FH of colorectal and breast cancer as well as smoking seem to be risk factors for the development of SI-NETs, while use of aspirin might be a protective factor. These factors partially overlap with those associated with CRC, but are different from those previously associated with pancreatic neuroendocrine tumors. These findings may suggest that the mechanisms of carcinogenesis for endocrine cells in different sites can be specific and similar to those of their exocrine counterparts.

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Risk Factors for Intraductal Papillary Mucinous Neoplasm (IPMN) of the Pancreas: A Multicentre Case–Control Study

Abstract: A previous history of diabetes, especially with insulin use, CP, and family history of PDAC are all relevant risk factors for the development of IPMN. These results suggest an overlap between certain risk factors for PDAC and IPMN.

Cited by 113 publications

References 32 publications

Intraductal Papillary Mucinous Neoplasms of the Pancreas: Challenges and New Insights

Intraductal Papillary Mucinous Neoplasms of the Pancreas: Challenges and New Insights

Association between the Risk Factors for Pancreatic Ductal Adenocarcinoma and Those for Malignant Intraductal Papillary Mucinous Neoplasm

Risk and Protective Factors for Small Intestine Neuroendocrine Tumors: A Prospective Case-Control Study

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