Backgrounds: In branch duct intraductal papillary mucinous neoplasms (IPMNs), the previous reports suggest the predictive factors for malignancy or invasive carcinoma by morphological features and symptoms (e.g. size of the cystic lesion, mural nodule, jaundice) Objectives: The purpose of the present study was to identify useful predictive factors for malignant branch duct IPMNs of the pancreas. Method: Among 77 IPMNs of the pancreas, 37 patients with branch duct IPMNs without main pancreatic duct dilatation (<6 mm) treated surgically at Hiroshima University Hospital from 1990 to 2005 were reviewed. These patients consisted of 27 patients with adenoma, 5 patients with borderline lesion, 4 patients with non-invasive carcinoma, and 1 patient with invasive carcinoma (According to WHO classification of tumours). Preoperative predictive factors of malignant IPMNs were analyzed among 13 factors including age, gender, pain, jaundice, diabetes, extrapancreatic malignancy, serum CEA, serum CA19-9, tumor location, diameter of cystic lesion, mural nodule, patulous papilla, and pancreatic juice examination (cytology, telomerase activity) by statistical analysis. Results: Table.1:Predictive factor for malignancy in Branch duct IPMN of the pancreas Pancreatic juice examination was the only significant factor associated with malignant IPMNs. Conclusions: Carried out single institution analysis showed predictive factor for malignant branch duct IPMNs of the pancreas. It is of note that asymptomatic branch duct IPMNs without typical morphological features can harbor malignant components. This study suggests that pancreatic juice examination may be indispensable for proper management of branch duct IPMNs.

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