In addition to a mural nodule and dilated MPD, several studies have found that cytology and/or tumor markers, including carcinoembryonic antigen (CEA) in the cystic fluid obtained by EUS-guided fine needle aspiration (EUS-FNA), or in the pancreatic juice obtained from MPD by endoscopic retrograde pancreatography (ERP), were useful to establish surgical indication for IPMN [36–41]. This evidence concerns the gene CEACAM5 and pancreatic intraductal papillary-mucinous neoplasm.