{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:49:23Z","timestamp":1786978163093,"version":"build-2736575974"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T00:00:00Z","timestamp":1652054400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100014188","name":"Ministry of Science and ICT, South Korea","doi-asserted-by":"publisher","award":["NRF\u20102017M3C9A5031591"],"award-info":[{"award-number":["NRF\u20102017M3C9A5031591"]}],"id":[{"id":"10.13039\/501100014188","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001321","name":"National Research Foundation","doi-asserted-by":"publisher","award":["NRF\u20102017M3C9A5031591"],"award-info":[{"award-number":["NRF\u20102017M3C9A5031591"]}],"id":[{"id":"10.13039\/501100001321","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background\/Purpose<\/jats:title>\n                    <jats:p>Surgical indications of main duct\u2010involved intraductal papillary mucinous neoplasm (IPMN), especially for main pancreatic duct (MPD) of 5\u20109\u2009mm, remain controversial. We aimed to predict malignancy risk of main duct\u2010involved IPMN.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Total 258 patients with main duct\u2010involved IPMN between 2000 and 2017 in our institute were retrospectively analyzed. Main duct IPMN was classified into segmental and diffuse\u2010type by dilated MPD pattern. Clinicopathologic features and predictive factors for malignancy were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 258 patients, 47 and 211 had pure main duct (segmental: 27, diffuse type: 20) and mixed type, respectively. Malignant IPMN presented higher in main duct type (66.0%) compared to mixed type (46.9%). The diffuse type (72.2%) had more invasive carcinoma than the segmental type (40.7%). Invasive IPMN risk increased proportionally to the MPD diameter (5\u2009\u2264\u2009MPD &lt;10\u2009mm vs 10\u2009\u2264\u2009MPD\u2009&lt;\u200915\u2009mm vs MPD\u2009\u2265\u200915\u2009mm; 23.4% vs 40.0% vs 48.6%). Symptoms, elevated serum carbohydrate antigen, MPD \u226510\u2009mm, mural nodule, thickened wall, and distal atrophy were independent predictive factors for malignancy. Patients with MPD of 5\u20109\u2009mm with at least one predictive factor had 35.0% of malignancy risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The invasive IPMN risk was different according to the dilated main duct pattern. Patients with main duct type, diffuse type, MPD \u226510\u2009mm, and MPD 5\u20109\u2009mm with at least one predictive factor should be candidates for immediate surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jhbp.1161","type":"journal-article","created":{"date-parts":[[2022,4,22]],"date-time":"2022-04-22T04:06:27Z","timestamp":1650600387000},"page":"1014-1024","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Prediction of malignancy in main duct or mixed\u2010type intraductal papillary mucinous neoplasms of the pancreas"],"prefix":"10.1002","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2041-4214","authenticated-orcid":false,"given":"Hye\u2010Sol","family":"Jung","sequence":"first","affiliation":[{"name":"Department of Surgery and Cancer Research Institute Seoul National University College of Medicine  Seoul South 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South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3171-2540","authenticated-orcid":false,"given":"Mirang","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Surgery and Cancer Research Institute Seoul National University College of Medicine  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung\u2010Bun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pathology Seoul National University College of Medicine  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1595-0135","authenticated-orcid":false,"given":"Hongbeom","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Surgery and Cancer Research Institute Seoul National University College of Medicine  Seoul South 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