Zhuge X, Zhou H, Chen L, et al. - Findings demonstrate an association of elevated serum ferritin with malignant intraductal papillary mucinous neoplasms (IPMNs). Serum ferritin could serve as a useful marker for detecting malignancy in IPMNs.

• Participants were 151 patients with pathologically confirmed IPMNs, in whom serum tumor biomarker (carbohydrate antigen 19–9 (CA19–9) and carcinoembryonic antigen (CEA)) levels and serum ferritin levels were measured.

• Higher serum ferritin levels were detected in malignant IPMNs vs in patients with nonmalignant IPMNs.

• Serum ferritin was revealed as an independent factor for malignant IPMNs development (odds ratio (OR) = 1.18).

• There was a similar trend between high serum ferritin (> 149 ng/ml) and malignant IPMNs (OR = 5.64).

• Serum ferritin showed a higher area under the curve (AUC) vs CEA and CA19–9 in detecting malignant IPMNs (AUC = 0.67 vs AUC = 0.58, 0.65).

• Performance with the combination of serum ferritin with IPMN type was similar to that of main pancreatic duct diameter and the combination of serum CA19–9 with IPMN types in detecting malignant IPMNs (AUC = 0.78 vs AUC = 0.79, 0.77) and invasive carcinoma (AUC = 0.77 vs AUC = 0.79, 0.79).