Considering the clinicopathologic variables that a significant difference between patients with IBCA and those with IBC might be closely related to prognosis, such variables were subsequently analyzed using Cox proportional hazards regression models.
The clinical characteristics of patients with IBCA are presented in [Table 1].
CT was the most commonly used imaging modality, and the typical findings associated with IBCA included multilocular cysts with thickened and irregular walls (30/34, 88.2%), internal septa (26/34, 76.5%), and mural nodules (29/34, 85.3%).
Because patients with IBC who undergo complete resection can achieve a better prognosis than those with IBCA, in order to identify prognostic factors for survival, we first compared the clinical characteristics of IBC patients with those of IBCA patients to identify risk factors associated with malignancy, considering that clinical variables showing a significant difference might also be factors associated with prognosis.
Although we did not detect a significant difference in the presence of mesenchymal stroma between patients with IBC and those with IBCA, this was identified as an important factor associated with prognosis by previous studies, [sup], so we included it in subsequent analyses.
The accurate diagnosis of IBCA is important in optimizing clinical decisions and patient prognosis.
As with IBC, the most common symptom associated with IBCA is abdominal pain or discomfort.
Although patients with IBCA had smaller tumors, their serum liver enzyme values were higher than those of patients with IBCs, and the difference was statistically significant.
Mural nodules arise from epithelial tissue, as does ductal adenocarcinoma, and are more commonly seen in patients with IBCA. [sup], Martel et al .
Because it is difficult to make a definitive preoperative diagnosis of IBCA and because IBC also has malignant potential, complete resection is recommended for any suspected biliary cystadenoma.