Skip to main content

Table 5 Diagnostic value of the absolute and relative criteria for pancreatic resection from the evidence-based European guidelines 2018 for predicting malignant IPMN. Analysis of the data for the 124 patients with IPMN who underwent surgery, and for the subgroup of 75 patient who duodenopancreatectomy or total pancreatectomy (PT) (shown in italics under each criterion)

From: Intraductal papillary mucinous neoplasms of the pancreas and European guidelines: importance of the surgery type in the decision-making process

Variables Sensitivity (95% CI) Specificity (95%CI) PPV (95% CI) NPV (95% CI) Accuracy (95% CI)
Absolute criteria
Solid component 29% (18–41) 87% (76–94) 69% (48–85) 55% (44–65) 58% (46–71)
Whipple/Total PT 35% 76% 70% 43% 51%
Jaundice 11% (4–21) 98% (91–99) 87% (47–99) 52% (43–61) 55% (44–68)
Whipple/Total PT 15% 97% 88% 42% 46%
Mural Nodule 16% (8–27) 85% (74–99) 53% (28–75) 50% (40–60) 50% (42–61)
Whipple/Total PT 7% 80% 34% 35% 35%
MD ≥ 10 mm 39% (26–51) 84% (73–91) 71% (52–84) 58% (46–68) 61% (48–79)
Whipple/Total PT 48% 76% 76% 48% 59%
At least two criteria (n = 20) 24% (14–36) 91% (84–97) 75% (59–91) 55% (44–64) 58% (44–67)
Whipple/Total PT 31% 76% 67% 41% 48%
At least three criteria (n = 9) 11% (4–21) 97% (88–96) 77% (40–97) 52% (42–61) 51% (40–60)
Whipple/Total PT 16% 94% 78% 41% 46%
Relative Criteria
Cyst ≥ 4 cm (*) 42% (29–55) 90% (80–96) 81% (63–93) 61% (50–71) 66% (54–81)
Whipple/Total PT 53% 76% 78% 50% 62%
MD 5–9.9 mm 47% (34–60) 66% (53–77) 58% (43–72) 55% (43–67) 56% (44–71)
Whipple/Total PT 35% 69% 64% 40% 48%
Acute pancreatitis 21% (11–36) 82% (72–91) 54% (43–66) 51% (41–61) 52% (43–64)
Whipple/Total PT 16% 80% 54% 38% 40%
New onset of diabetes 3% (0.4–11) 88% (78–93) 22% (3–60) 48% (38–57) 46% (39–59)
Whipple/Total PT 9% 83% 45% 37% 38%
Rapid growth rate 1% (0.3–19) 83% (72–92) 37% (15–64) 48% (38–58) 47% (36–59)
Whipple/Total PT 11% 90% 63% 39% 42%
At least two criteria
(n = 30)
30% (19–43) 82% (70–90) 63% (43–80) 54% (43–64) 56% (45–68)
Whipple/Total PT 22% 63% 48% 34% 38%
At least three criteria
(n = 9)
14% (5–23) 100% (94–100) 100% (63–100) 54% (44–62) 57% (45–70)
Whipple/Total PT 9% 100% 100% 41% 44%
  1. 95% CI: 95% confidence interval
  2. PPV: positive predictive value; NPV: negative predictive value
  3. *: Cyst ≥3 cm (worrisome feature in the Fukuoka consensus guidelines 2012) had the following performances in the present study: sensitivity 66%, specificity 65%, PPV 65%, NPV 65% and accuracy 65%