Rachel DJ. Cruz Nieves, MD1, Evan R. Adler, MD1, Anjuli K. Luthra, MD2, Saraswathi Cappelle, DO2, Aamir Dam, MD2, Luis Pena, MD2, Mark Friedman, MD2, Schaffer Mok, MD2 1University of Virginia, Charlottesville, VA; 2Moffitt Cancer Center, Tampa, FL Introduction: Mucinous neoplasms (MN) such as intraductal papillary mucinous neoplasms (IPMNs) and mucinous cystic neoplasms (MCNs) are precursors to pancreatic cancer. Endoscopic ultrasound-guided fine needle aspirate (EUS-FNA) CEA is 75% sensitive and 84% specific in the differentiation MN and non-MN lesions in the pancreas. Despite this value, certain MNs still exhibit normal CEA values, leading to incorrect classification, management, and inappropriate prognostic classification. Methods: In a cohort of individuals with pathologically proven MN, we compared characteristics of individuals with a positive (+) CEA aspiration (>192 ng/mL) versus normal CEA level (< 192). We completed a retrospective review of 117 patients, at an academic tertiary cancer center from January 2022 to February 2024, who had undergone EUS-FNA of their pathologically proven pancreatic MN. Of those 40 (34.2%) had +CEA and the remaining normal. We then compared other laboratory findings between these two groups, including amylase and glucose as well as comorbidities, location, and epidemiology. Results: There were no differences in gender or age in the CEA+ v. normal groups. Glucose levels were significantly higher in samples with CEA< 192 (mean 27.9mg/dL v. 12.52mg/dL, p< 0.05). Amylase was also higher on average in the CEA+ groups (mean 13,905U/L v. 3317U/L, p=0.58). In terms of comorbidities, in the normal CEA group, 22% had Diabetes mellitus (DM) compared to 47% of the +CEA group. No additional differences were detected. Discussion: In this cohort of MNs, mean cyst aspirate glucose values were different in CEA+ v. normal patients. If further validated, this may increase the clinician’s understanding of the appropriate numeric cut-offs of cyst glucose levels for individuals with MNs.
Figure: Figure 1. Glucose levels compared via T two tailed T test between the two groups (CEA>192 vs CEA <192). Significantly decreased glucose value in CEA >192 cohort (P <0.05).
Figure: Figure 2. Amylase, though not significant between groups was on average lower in CEA>192 samples compared to CEA <192.
Disclosures: Rachel Cruz Nieves indicated no relevant financial relationships. Evan Adler indicated no relevant financial relationships. Anjuli Luthra: Boston Scientific – Consultant. Cook Medical – Speakers Bureau. Saraswathi Cappelle: Olympus – Consultant. Aamir Dam indicated no relevant financial relationships. Luis Pena indicated no relevant financial relationships. Mark Friedman indicated no relevant financial relationships. Schaffer Mok: Amgen – Consultant. Steris – Consultant.
Rachel DJ. Cruz Nieves, MD1, Evan R. Adler, MD1, Anjuli K. Luthra, MD2, Saraswathi Cappelle, DO2, Aamir Dam, MD2, Luis Pena, MD2, Mark Friedman, MD2, Schaffer Mok, MD2. P2210 - Differences in Aspirate Glucose Cut-Offs in Cea versus Non-Cea Secreting Mucinous Pancreas Cysts: A Cohort Review, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
