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Prediction Rule of Cai et al for Estimating the Risk of Pancreatic Cancer in a Patient with Chronic Pancreatitis and a Focal Mass Lesion

Purpose: To estimate the risk that a patient has a pancreatic cancer based on the prediction rule of Cai et al.

Description

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.


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Specialty

Objective

ICD-10