Multivariate analysis (based on the binary logistic regression) of factors identified as significant in the univariate analysis showed that cyst wall enhancement (P = 0.001), serum CEA ≥5 ng/ml (P = 0.047), serum CA 19-9 ≥37 u/ml (P < 0.001), MPD diameter ≥10 mm (P = 0.029), cyst size ≥3 cm (P = 0.006), and NLR ≥2 (P = 0.005) were independent risk factors for malignant IPMN. The gene discussed is CEACAM5; the disease is pancreatic intraductal papillary-mucinous neoplasm.