S174 Differences in Aspirate Glucose Cut-Offs in Cea vs Non-Cea Secreting Mucinous Pancreas Cysts: A Cohort Review

Introduction: Mucinous neoplasms (MN) such as intraductal papillary mucinous neoplasms (IPMNs) and mucinous cystic neoplasms are precursors to pancreatic cancer. Endoscopic ultrasound-guided fine needle aspirate 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) vs 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 endoscopic ultrasound-guided fine needle aspirate 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 2 groups, including amylase and glucose as well as comorbidities, location, and epidemiology. Results: There were no differences in gender or age in the CEA+ vs normal groups. Glucose levels were significantly higher in samples with CEA< 192 (mean 27.9 mg/dL vs 12.52 mg/dL, P < 0.05). Amylase was also higher on average in the CEA+ groups (mean 13,905 U/L vs 3317 U/L, P = 0.58). In terms of comorbidities, in the normal CEA group, 22% had diabetes mellitus compared to 47% of the +CEA group. No additional differences were detected. Conclusion: In this cohort of MNs, mean cyst aspirate glucose values were different in CEA+ vs 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.