Intraductal papillary mucinous neoplasms (IPMNs) can potentially undergo malignant transformation. Studies have shown that high-density lipoprotein cholesterol (HDL-c) was associated with the risk of cancer. In this study, the association between HDL-c and the incidence of malignancy in IPMNs was investigated. 226 patients with histologically proven IPMNs who underwent surgery were included in the present study. Patients were assigned to a training group (n = 151) and validation group (n = 75). Patients’ demographic information, clinical data, and histopathological evaluation findings were obtained from medical records. Malignant IPMNs were defined as lesions that showed high grade dysplasia and invasive carcinoma. Logistic regression analyses were used to show the association between HDL-c and malignant IPMNs. Receiver operating characteristic (ROC) curves were generated to analyze predictive performance. The prevalence of low HDL-c levels was higher in patients with malignant IPMNs than in those with non-malignant IPMNs (P < 0.01) in both the training group and validation group. The prevalence of malignant IPMNs decreased with an increase in HDL-c levels both in patients with all types of IPMNs, as well as in those with branch-duct IPMNs (BD-IPMNs).Logistic analysis showed that low HDL-c levels were associated with malignant IPMNs (odds ratio (OR) = 20.56, 95 % confidence interval (CI): 2.58–163.64, P < 0.01) in all types of IPMNs and BD-IPMNs (OR = 17.6, 95 %CI: 1.16–268.46, P = 0.02 ).The predictive performance of mural nodules plus low HDL-c levels was higher than that of mural nodules alone or mural nodules plus cyst size for the identification of malignant BD-IPMNs. HDL-c levels may serve a potential biomarker for identifying malignant IPMNs and improve the predictive ability of malignancy in BD-IPMNs.

中文翻译：

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低高密度脂蛋白胆固醇水平与恶性导管内乳头状粘液性肿瘤相关：一项多中心研究

导管内乳头状粘液性肿瘤 (IPMNs) 可能发生恶性转化。研究表明，高密度脂蛋白胆固醇 (HDL-c) 与患癌症的风险有关。在这项研究中，研究了 HDL-c 与 IPMNs 恶性肿瘤发生率之间的关联。本研究纳入了 226 名经组织学证实的 IPMN 接受手术的患者。患者被分配到训练组（n = 151）和验证组（n = 75）。从医疗记录中获得患者的人口统计信息、临床数据和组织病理学评估结果。恶性 IPMN 被定义为表现出高度不典型增生和浸润性癌的病变。逻辑回归分析用于显示 HDL-c 与恶性 IPMN 之间的关联。生成接收器操作特征 (ROC) 曲线以分析预测性能。在训练组和验证组中，恶性 IPMNs 患者低 HDL-c 水平的发生率高于非恶性 IPMNs 患者（P < 0.01）。恶性 IPMNs 的患病率随着 HDL-c 水平的升高而降低，无论是在所有类型的 IPMNs 患者中，还是在那些患有分支导管 IPMNs (BD-IPMNs) 的患者中。Logistic 分析表明，低 HDL-c 水平与在所有类型的 IPMNs 和 BD-IPMNs 中均伴有恶性 IPMNs（优势比 (OR) = 20.56, 95 % CI: 2.58–163.64, P < 0.01）（OR = 17.6, 95 %CI: 1.16–268.46, P = 0.02)。附壁结节加低 HDL-c 水平的预测性能高于仅附壁结节或附壁结节加囊肿大小对恶性 BD-IPMNs 的识别。HDL-c 水平可作为识别恶性 IPMN 的潜在生物标志物，并提高对 BD-IPMN 恶性肿瘤的预测能力。