为确定不完全隆起导管扩张（UDD）是否增加了福冈阳性乳头状黏液性肿瘤（IPMNs）的高级别异型增生或浸润性癌（HGD/IC）的风险。虽然被分类为一支亚型导管，但不完全隆起导管是胰腺腹侧原基的主导管。我们假设，像主导管扩张一样，UDD会增加HGD/IC的附加风险。在马萨诸塞州总医院进行的一项回顾性队列研究中，共有467名符合纳入标准的IPMNs患者接受了手术切除。我们使用多变量 logistic 回归分析UDD（定义为≥4mm）和HGD/IC之间的关联性，控制了福冈风险标准。在第二次分析中，将建模重复在194名胰腺颈、体或尾的腹侧亚型导管IPMNs（BD-IPMNs）患者中。手术时的平均年龄为70岁，其中229（49％）位患者为女性。总共，267（57％）位患者仅具有可疑病理特征，200（43％）位患者至少有一种高风险特征。共有164（35％）位患有UDD的患者，其中118（73％）位患有HGD/IC。在多变量分析中，即使控制福冈风险因素，UDD仍然使得患HGD / IC 的几率增加了2.8倍（95％ CI：1.8-4.4，P <0.001）。所有患有UDD的患者中HGD/IC的发生率为73％，相比之下，高风险标志物患者为74％，主导管IPMN患者为73％。在第二次分析中，UDD使背部BD-IPMNs患者的HGD/IC几率增加了3.2倍（95％ CI：1.3-7.7，P = 0.010）。UDD会增加当前福冈标准未计算的HGD / IC的附加风险。进一步研究可以将这项研究扩展到福冈阴性患者，包括未接受手术治疗的患者。版权所有 © 2023 Wolters Kluwer Health，Inc. 保留所有权利。

To determine whether uncinate duct dilatation (UDD) increases the risk of high-grade dysplasia or invasive carcinoma (HGD/IC) in Fukuoka-positive intraductal papillary mucinous neoplasms (IPMNs).Though classified as a branch duct, the uncinate duct is the primary duct of the pancreatic ventral anlage. We hypothesized that UDD, like main duct dilatation, confers additional risk for HGD/IC.A total of 467 patients met inclusion criteria in a retrospective cohort study of surgically-resected IPMNs at the Massachusetts General Hospital. We used multivariable logistic regression to analyze the association between UDD (defined as ≥4 mm) and HGD/IC, controlling for Fukuoka risk criteria. In a secondary analysis, the modeling was repeated in the 194 patients with dorsal branch duct IPMNs (BD-IPMNs) in the pancreatic neck, body, or tail.Mean age at surgery was 70, and 229 (49%) patients were female. In total, 267 (57%) patients had only worrisome features and 200 (43%) had at least one high-risk feature. UDD was present in 164 (35%) patients, of whom 118 (73%) had HGD/IC. On multivariable analysis, UDD increased the odds of HGD/IC by 2.8-fold, even while controlling for Fukuoka risk factors (95% CI: 1.8-4.4, P<0.001). Prevalence of HGD/IC in all patients with UDD was 73%, compared to 74% in patients with high-risk stigmata and 73% in patients with main duct IPMNs. In the secondary analysis, UDD increased the odds of HGD/IC by 3.2-fold in patients with dorsal BD-IPMNs (95% CI: 1.3-7.7, P=0.010).UDD confers additional risk for HGD/IC unaccounted for by current Fukuoka criteria. Further research can extend this study to Fukuoka-negative patients, including unresected patients.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.