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Article summary:
1. Low levels of high-density lipoprotein cholesterol (HDL-c) are associated with malignant intraductal papillary mucinous neoplasms (IPMNs).
2. Logistic regression analyses showed that low HDL-c levels were associated with malignant IPMNs in all types of IPMNs and branch duct IPMNs (BD-IPMNs).
3. 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.
Article analysis:
The article is generally reliable, as it is based on a multicenter study involving 226 patients with histologically proven IPMNs who underwent surgery. The study used logistic regression analyses to show the association between HDL-c and malignant IPMNs, and receiver operating characteristic (ROC) curves to analyze predictive performance. The results showed that low HDL-c levels were associated with malignant IPMNs in all types of IPMNs and BD-IPMNs, and that 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.
However, there are some potential biases in the article which should be noted. Firstly, the sample size is relatively small, which may limit the generalizability of the findings. Secondly, there is no mention of any potential confounding factors such as age, gender, lifestyle factors etc., which could have an effect on the results. Thirdly, there is no discussion about possible risks associated with low HDL-c levels or how this information can be used to inform clinical practice. Finally, there is no mention of any alternative treatments or interventions which could be used to reduce risk or improve outcomes in patients with malignant IPMNs.