PANCREATIC CYST FLUID INTERLEUKIN-1 BETA (IL-1Β) LEVEL IN PREDICTING THE RISK OF MALIGNANCY IN PANCREATIC CYSTS.

Aims The of the current study was to determine the predictive value of cystic fluid IL-1β in detection of malignant pancreatic cystic lesions and its correlation to the different degrees of dysplasia.

Methods Between January 2018 and November 2020, 50 patients underwent EUS-guided fine needle aspiration (EUS-FNA) for cyst fluid analysis at the Endoscopy unit. Patients were pre-endoscopically consented. Correlative studies on cyst fluid carcinoembryonic antigen (CEA), cyst fluid interleukin 1beta (IL-1 β) and fine needle aspiration (FNA) cytology were performed on a subset of these patients. Demographics and clinical data including preendoscopic serum CA 19-9 were supplemented through electronic medical record review. Pancreatic fluid levels of IL-1β were measured using commercially available ELISA kits (Cat DLB-50; R&D, Minneapolis, Minn and RPN222; GE Healthcare Life Sciences, Pittsburgh, Penn). The threshold value of IL-1β (>50 pg/mL)

Results Cyst fluid IL-1 β can differentiate between benign and malignant cysts at cutoff value > 200 pg/ml; the sensitivity and specificity were 84.00% and 56.00% respectively and also can differentiate between mucinous and non- mucinous pancreatic cysts at cutoff value>150 pg/ml; the sensitivity and specificity were 83.33% and 53.78% respectively, but cannot differentiate between degrees of dysplasia of IPMN.

Table 1 Univariate logistic regression analysis for predictors of malignancy.

	B	p value	Odds ratio (OR)	95% C.I. for OR
Age>55 ys	3.401	0.000	30	5.294 − 170.015
Size of cyst ≤ 55mm	1.992	0.007	7.333	1.716 − 31.343
C.F IL1b > 200 pg/ml	3.520	0.001	33.800	3.895 – 293.305
Mucin stain	3.386	0.002	29.545	3.428 – 254.667

Conclusions Pancreatic cyst fluid IL-1β can be a promising biochemical cyst fluid marker to differentiate between mucinous and non-mucinous cysts as well as benign and malignant cysts. Further larger studies are needed to validate its role.

Publication History

Article published online:
14 April 2022