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Multicenter Study
. 2021 Aug 28;20(1):94.
doi: 10.1186/s12944-021-01523-8.

Low high-density lipoprotein cholesterol levels are associated with malignant intraductal papillary mucinous neoplasms: A multicenter study

Cheng Wang #  1 , Tingting Lin #  2 , Xinru Wang #  2 , Zhicheng Yu  2 , Xiaoling Zhuge  3 , Wenjing Cui  2 , Miaomiao Wang  2 , Zhongqiu Wang  2 , Chuangen Guo  4 , Xiao Chen  5
Affiliations
Multicenter Study

Low high-density lipoprotein cholesterol levels are associated with malignant intraductal papillary mucinous neoplasms: A multicenter study

Cheng Wang et al. Lipids Health Dis. .

Abstract

Background: 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.

Materials and methods: 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.

Results: 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.

Conclusions: HDL-c levels may serve a potential biomarker for identifying malignant IPMNs and improve the predictive ability of malignancy in BD-IPMNs.

Keywords: HDL-cholesterol; branch duct; intraductal papillary mucinous neoplasms; invasive carcinoma; lipids; malignancy; pancreas.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
The association between the prevalence of malignant intraductal papillary mucinous neoplasms (IPMNs) and high-density lipoprotein cholesterol (HDL-c) levels. The prevalence of malignancy decreased with an increase of HDL-c in all IPMNs (A) and branch duct intraductal papillary mucinous neoplasm (BD-IPMNs) (B)
Fig. 2
Fig. 2
The receiver operating characteristic (ROC) curves of variables in predicting malignant intraductal papillary mucinous neoplasms (IPMNs). A: mural nodule plus MPD diameter and Ca19-9 or low high-density lipoprotein cholesterol (HDL-c) levels in predicting malignant IPMNs. B: mural nodule alone, mural nodule plus cyst size, and mural nodule plus low HDL-c levels in predicting malignant branch duct IPMNs (BD-IPMNs)
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