The Analysis Of Correlative Risk Factors Of Malignant Pancreatic Cystic Neoplasms

Objective: To analyze the risk factors of malignant pancreatic cystic neoplasms(PCNs),and establish a valuable risk predicting system of pancreatic cystic neoplasms with malignancy by retrospectively summarizing the clinical data of patients with PCNs.Methods: The clinical data of patients with PCNs who received surgical treatment at Shengjing Hospital Affiliated to China Medical University from February 2012 to August 2018 were collected.Patients were divided into benign group and malignant group(borderline and malignant)according to postoperative pathological results.The analysis indicators included patients' genders,age,histories of diabetes,clinical symptoms(abdominal pain,bloating,abdominal mass,jaundice,weight loss),hematological examinations(serum bilirubin,serum CEA,serum CA19-9,imaging features(tumor location,diameter,solid components,thickening or nodules in cyst wall,dilatation of pancreatic duct,lymphadenectasis in abdominal cavity)and pathological diagnosis.SPSS 23.0 statistical software was used to analyze data.first,univariate analysis was used,among which measurement data was tested with independent sample t test,count data was tested by ?2 or Fisher's exact probability test.After that,the possible related factors were conducted by multi-factor Logistic analysis of regression,P<0.05 is considered statistically significant.Finally,Subjecting receiver operating characteristic(ROC)curve,and area under the curve(AUC)was measured.The optimal cut-off was selected in reference to the Youden index.Results: 1.Univariate analysis showed that male,advanced age,clinical symptoms,increasing serum CA19-9,increasing serum bilirubin,lymphadenectasis in abdominal cavity were closely associated with malignant PCNs(P<0.05).2.Multivariate analysis showed that male,advanced age,clinical symptoms,increasing serum CA19-9,lymphadenectasis in abdominal cavity were closely associated with malignant PCNs(P<0.05).increasing serum bilirubin was excluded.(P>0.05).3.A valuable risk predicting system of malignant PCNs was established,the area under the receiver operating curve(ROC)was 0.857(95%CI: 0.772-0.942).The optimal cut-off was 0.21 in reference to the Youden index,The sensitivity was 0.769,and the specificity was 0.857.Conclusion: male,advanced age,clinical symptoms,increasing serum CA19-9,lymphadenectasis in abdominal cavity were independent risk factors for malignant PCNs.