Tu1921 RBP-J Gene May Be Associated With Bone Mineral Density of IBD Patients

Abstract

macrocystic or microcystic morphology, and impression of a pseudocyst] were noted. FNA results, including cyst fluid CEA , and cytology features of mucin, cellular atypia or cancer were recorded. Univariate analysis (Fisher's exact and Mann-Whitney U test) was performed followed by multivariate logistic regression analysis to identify if CEA was an independent predictor for MCN. ROC curves were generated for CEA levels to evaluate its diagnostic characteristics. Results: 2407 pts met inclusion criteria and 1861 (77.6%) underwent EUSFNA [mean age 63 yrs, 87% Caucasians, 58% females, and mean pancreatic cyst size 26 mm]. 376 pts underwent surgery (37% Whipple's surgery, 45% distal pancreatectomy, 18% others) and cancer on cytology was noted in 138 pts. Based on the gold standard, there were 440 pts with MCN (including IPMN) and 882 NMCN. On univariate analysis, the median values of CEA in MCN were significantly higher than that of NMCN (126.9 vs. 21.65, p < 0.001). On multivariate analysis, CEA [OR = 1.3 (1.1 1.6), p < 0.01] was a statistically significant predictor for MCN while adjusting for mucin on cytology, presence of solid mass on EUS, mural nodule, and multilocularity. Area under ROC curve was 0.74 (0.70 0.77, p<0.01) for CEA (cut off of 92.9 ng/ml sensitivity, 70% and specificity, 64%) (Figure). The traditional cut off of 192 ng/ml yielded a sensitivity of 59% and specificity of 73% in identifying MCN. Conclusions: This large multicenter study demonstrates that cyst fluid CEA levels have an unacceptable accuracy level in differentiating MCN and NMCN of the pancreas limiting its applicability in clinical practice. Future studies should focus on novel markers in cyst fluid to improve the risk stratification for diagnosis, cancer risk and surveillance of pancreatic cystic neoplasms. Table: AUC, Sensitivity and specificity of CEA in differentiating MCN from NMCN.