Table 2.
The diagnostic accuracy of telomerase activity, imaging and clinical factors for predicting high-grade dysplasia/invasive cancer
| Findings | Cut-off | Sensitivity (%)(95% CI) | Specificity (%)(95% CI) | Accuracy (%) | PPV (%) | NPV (%) |
|---|---|---|---|---|---|---|
| All cases (n = 119)* | ||||||
| Cyst appearance | Mucinous | 83.9 (66.3–94.6) | 63.6 (52.7–73.6) | 68.9 | 44.8 | 91.8 |
| Cyst size | ≥30 mm | 32.3 (16.7–51.4) | 64.8 (53.9–74.7) | 56.3 | 24.4 | 73.1 |
| MPD dilatation | ≥10 mm | 25.8 (11.9–44.6) | 93.2 (85.8–97.5) | 84.0 | 57.1 | 78.1 |
| MPD dilatation | ≥5 mm | 58.1 (39.1–75.5) | 80.7 (70.9–88.3) | 74.8 | 51.4 | 84.5 |
| Mural nodule | Present | 58.1 (39.1–75.5) | 71.6 (61.0–80.7) | 68.1 | 41.9 | 82.9 |
| Telomerase activity | ≥730 copies/L cyst fluid | 74.2 (55.4–82.1) | 93.2 (85.8–97.5) | 88.2 | 79.3 | 91.1 |
| IPMN cases (n = 74) | ||||||
| Cyst appearance | Mucinous | 83.9 (66.3–94.6) | 41.9 (27.0–57.9) | 59.5 | 51.0 | 78.3 |
| Cyst size | ≥30 mm | 32.3 (16.7–51.4) | 24.4 (58.8–86.5) | 56.8 | 47.6 | 60.4 |
| MPD dilatation | ≥10 mm | 25.8 (11.9–44.6) | 86.1 (72.1–94.7) | 60.8 | 57.1 | 61.7 |
| MPD dilatation | ≥5 mm | 58.1 (39.1–75.5) | 67.4 (51.5–80.9) | 63.5 | 56.3 | 69.1 |
| Mural nodule | Present | 58.6 (39.1–75.5) | 74.4 (58.8–86.5) | 67.6 | 62.1 | 71.1 |
| Telomerase activity | ≥730 copies/L cyst fluid | 74.2 (55.4–88.1) | 86.1 (72.1–94.7) | 81.1 | 79.3 | 82.2 |
*
discovery and validation sets combined (samples without prior thawing). MPD, main pancreatic duct; CI, confidence interval; PPV, positive predictive value; NPV, negative predictive value