Cai et al developed a prediction rule (score) for predicting the risk of pancreatic cancer in a patient with chronic pancreatitis, a focal pancreatic mass, and a negative EUS-FNA cytology study. The authors are from Second Military Medical University and Fudan University in Shanghai.
Patient population: Chinese
Patient selection: chronic pancreatitis, pancreatic mass lesion(s) and negative endoscopic ultrasound guided fine needle aspiration (EUS-FNA).
Study: logistic regression analysis
Parameters:
(1) gender
(2) location of mass lesion
(3) number of mass lesions
(4) serum direct bilirubin
(5) serum CA 19-9
Parameter |
Finding |
Points |
---|---|---|
gender |
male |
0 |
|
female |
2 |
location of mass in pancreas |
head |
0 |
|
body |
3 |
|
tail |
1 |
number of mass lesions |
1 |
0 |
|
2 or more |
3 |
serum direct bilirubin |
<= 7 µmol/L |
0 |
|
> 7 µmol/L |
1 |
serum CA 19-9 |
<= 37 U/mL |
0 |
|
> 37 U/mL |
1 |
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score 10
• The higher the score the greater the likelihood of a pancreatic cancer being present.
Total Score |
Risk Group |
---|---|
0 to 3 |
low (13-18%) |
4 to 10 |
high (53%) |
Limitations:
• The method and reference ranges for direct bilirubin and CA 19-9 were not stated.
Performance:
• The AUC for the ROC curve was 0.72 which is mediocre.
Purpose: To estimate the risk that a patient has a pancreatic cancer based on the prediction rule of Cai et al.
Specialty: Hematology Oncology, Surgery, general, Gastroenterology
Objective: risk factors
ICD-10: C25, K86.0, K86.1,