Skip to main content

Advertisement

SpringerLink
Log in

Clinical importance of precursor lesions in the pancreas

  • Topics: Current understanding of precursors to pancreatic cancer
  • Published:
Journal of Hepato-Biliary-Pancreatic Surgery

Abstract

Three distinct noninvasive precursor lesions to invasive ductal adenocarcinoma of the pancreas have been described. These include the mucinous cystic neoplasm, intraductal papillary mucinous neoplasm, and pancreatic intraepithelial neoplasia. The early detection and treatment of these lesions can interrupt the progression of a curable noninvasive precursor to an almost uniformly deadly invasive cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. A Jemal T Murray E Ward A Samuels RC Tiwari A Ghafoor et al. (2005) ArticleTitleCancer statistics, 2005 CA Cancer J Clin 55 10–30 Occurrence Handle15661684

    PubMed  Google Scholar 

  2. L Tabar B Vitak HH Chen SW Duffy MF Yen CF Chiang et al. (2000) ArticleTitleThe Swedish two-county trial twenty years later. Updated mortality results and new insights from long-term follow-up Radiol Clin North Am 38 625–51 Occurrence Handle10943268 Occurrence Handle10.1016/S0033-8389(05)70191-3 Occurrence Handle1:STN:280:DC%2BD3cvhsFChtQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  3. Elkin EB, Hudis C, Begg CB, Schrag D. The effect of changes in tumor size on breast carcinoma survival in the US: 1975–1999. Cancer 2005

  4. DA Berry KA Cronin SK Plevritis DG Fryback L Clarke M Zelen et al. (2005) ArticleTitleEffect of screening and adjuvant therapy on mortality from breast cancer N Engl J Med 353 1784–92 Occurrence Handle16251534 Occurrence Handle10.1056/NEJMoa050518 Occurrence Handle1:CAS:528:DC%2BD2MXhtFKrtLbN

    Article  PubMed  CAS  Google Scholar 

  5. JA O'Shaughnessy GJ Kelloff GB Gordon AJ Dannenberg WK Hong CJ Fabian et al. (2002) ArticleTitleTreatment and prevention of intraepithelial neoplasia: an important target for accelerated new agent development Clin Cancer Res 8 314–46 Occurrence Handle11839647

    PubMed  Google Scholar 

  6. DA Boyes AJ Worth HK Fidler (1970) ArticleTitleThe results of treatment of 4389 cases of preclinical cervical squamous carcinoma J Obstet Gynaecol Br Commonw 77 769–80 Occurrence Handle5458765 Occurrence Handle1:STN:280:DyaE3c3ptVKruw%3D%3D

    PubMed  CAS  Google Scholar 

  7. RH Hruban DS Klimstra MB Pitman (2007) Atlas of tumor pathology. Tumors of the pancreas Armed Forces Institute of Pathology Washington, DC

    Google Scholar 

  8. RE Wilentz J Albores-Saavedra RH Hruban (2000) ArticleTitleMucinous cystic neoplasms of the pancreas Semin Diagn Pathol 17 31–42 Occurrence Handle10721805 Occurrence Handle1:STN:280:DC%2BD3c7osVygsg%3D%3D

    PubMed  CAS  Google Scholar 

  9. WH Westra PJ Sturm P Drillenburg MA Choti DS Klimstra J Abores-Saavedra et al. (1998) ArticleTitleK-ras oncogene mutations in osteoclast-like giant cell tumors of the pancreas and liver: genetic evidence to support origin from the duct epithelium Am J Surg Pathol 22 1247–54 Occurrence Handle9777987 Occurrence Handle10.1097/00000478-199810000-00010 Occurrence Handle1:STN:280:DyaK1cvkvFCitQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  10. W van den Berg M Tascilar GJ Offerhaus J Albores-Saavedra BM Wenig RH Hruban et al. (2000) ArticleTitlePancreatic mucinous cystic neoplasms with sarcomatous stroma: molecular evidence for monoclonal origin with subsequent divergence of the epithelial and sarcomatous components Mod Pathol 13 86–91 Occurrence Handle10658914 Occurrence Handle10.1038/modpathol.3880013 Occurrence Handle1:STN:280:DC%2BD3c7it1Shtg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  11. GL Hyde JB Davis RD McMillin M McMillin (1984) ArticleTitleMucinous cystic neoplasm of the pancreas with latent malignancy Am Surg 50 225–9 Occurrence Handle6712017 Occurrence Handle1:STN:280:DyaL2c7ns1ymsA%3D%3D

    PubMed  CAS  Google Scholar 

  12. J Le Borgne L de Calan C Partensky (1999) ArticleTitleCystadenomas and cystadenocarcinomas of the pancreas: a multiinstitutional retrospective study of 398 cases Frech Surg Assoc Ann Surg 230 152–61 Occurrence Handle1:STN:280:DyaK1Mznsl2gtQ%3D%3D

    CAS  Google Scholar 

  13. JG Probstein HT Blumenthal (1960) ArticleTitleProgressive malignant degeneration of a cystadenoma of the pancreas Arch Surg 81 683–9 Occurrence Handle13738110 Occurrence Handle1:STN:280:DyaF3c%2FlslOkug%3D%3D

    PubMed  CAS  Google Scholar 

  14. JF Flejou B Boulange P Bernades J Belghiti D Henin (1996) ArticleTitlep53 protein expression and DNA ploidy in cystic tumors of the pancreas Pancreas 13 247–52 Occurrence Handle8884845 Occurrence Handle1:STN:280:DyaK2s%2FjvFaqsQ%3D%3D

    PubMed  CAS  Google Scholar 

  15. CA Iacobuzio-Donahue RE Wilentz P Argani CJ Yeo JL Cameron SE Kern et al. (2000) ArticleTitleDpc4 protein in mucinous cystic neoplasms of the pancreas: frequent loss of expression in invasive carcinomas suggests a role in genetic progression Am J Surg Pathol 24 1544–8 Occurrence Handle11075857 Occurrence Handle10.1097/00000478-200011000-00011 Occurrence Handle1:STN:280:DC%2BD3M%2FjtlGrsg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  16. RE Jimenez AL Warshaw K Z'graggen WH Werner DZ Taylor PA Corris et al. (1999) ArticleTitleSequential accumulation of K-ras mutations and p53 overexpression in the progression of pancreatic mucinous cystic neoplasms to malignancy Ann Surg 230 501–11 Occurrence Handle10522720 Occurrence Handle10.1097/00000658-199910000-00006 Occurrence Handle1:STN:280:DyaK1MvltVGmtw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  17. J Lüttges B Feyerabend T Buchelt M Pacena G Klöppel (2002) ArticleTitleThe mucin profile of noninvasive and invasive mucinous cystic neoplasms of the pancreas Am J Surg Pathol 26 466–71 Occurrence Handle11914624 Occurrence Handle10.1097/00000478-200204000-00008

    Article  PubMed  Google Scholar 

  18. MG Sarr HA Carpenter LP Prabhakar TF Orchard S Hughes JA van Heerden et al. (2000) ArticleTitleClinical and pathologic correlation of 84 mucinous cystic neoplasms of the pancreas: can one reliably differentiate benign from malignant (or premalignant) neoplasms? Ann Surg 231 205–12 Occurrence Handle10674612 Occurrence Handle10.1097/00000658-200002000-00009 Occurrence Handle1:STN:280:DC%2BD3c7jslSktQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  19. K Yamaguchi M Enjoji (1987) ArticleTitleCystic neoplasms of the pancreas Gastroenterology 92 1934–43 Occurrence Handle3471621 Occurrence Handle1:STN:280:DyaL2s7ptFKltA%3D%3D

    PubMed  CAS  Google Scholar 

  20. AL Warshaw CC Compton KB Lewandrowski G Cardenosa PR Mueller (1990) ArticleTitleCystic tumors of the pancreas. New clinical, radiologic, and pathologic observations in 67 patients Ann Surg 212 432–45 Occurrence Handle2171441 Occurrence Handle10.1097/00000658-199010000-00006 Occurrence Handle1:STN:280:DyaK3M%2FisVegtA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  21. G Zamboni A Scarpa G Bogina C Iacono C Bassi G Talamini et al. (1999) ArticleTitleMucinous cystic tumors of the pancreas: clinicopathological features, prognosis, and relationship to other mucinous cystic tumors Am J Surg Pathol 23 410–22 Occurrence Handle10199470 Occurrence Handle10.1097/00000478-199904000-00005 Occurrence Handle1:STN:280:DyaK1M3htlGlsA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  22. RE Wilentz J Albores-Saavedra M Zahurak MA Talamini CJ Yeo JL Cameron et al. (1999) ArticleTitlePathologic examination accurately predicts prognosis in mucinous cystic neoplasms of the pancreas Am J Surg Pathol 23 1320–7 Occurrence Handle10555000 Occurrence Handle10.1097/00000478-199911000-00002 Occurrence Handle1:STN:280:DC%2BD3c%2FitFCksw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  23. ST Chari D Yadav TC Smyrk EP DiMagno LJ Miller M Raimondo et al. (2002) ArticleTitleStudy of recurrence after surgical resection of intraductal papillary mucinous neoplasm of the pancreas Gastroenterology 123 1500–7 Occurrence Handle12404225 Occurrence Handle10.1053/gast.2002.36552

    Article  PubMed  Google Scholar 

  24. NV Adsay C Pierson F Sarkar J Abrams D Weaver K Conlon et al. (2001) ArticleTitleColloid (mucinous noncystic) carcinoma of the pancreas Am J Surg Pathol 25 26–42 Occurrence Handle11145249 Occurrence Handle10.1097/00000478-200101000-00003 Occurrence Handle1:STN:280:DC%2BD3M%2Fnt1Gltg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  25. M D'Angelica MF Brennan AA Suriawinata DS Klimstra KC Conlon (2004) ArticleTitleIntraductal papillary mucinous neoplasms of the pancreas: an analysis of clinicopathologic features and outcome Ann Surg 239 400–8 Occurrence Handle15075659 Occurrence Handle10.1097/01.sla.0000114132.47816.dd

    Article  PubMed  Google Scholar 

  26. G Kobayashi N Fujita Y Nada K Ito J Horaguchi O Takasawa et al. (2005) ArticleTitleMode of progression of intraductal papillary–mucinous tumor of the pancreas: analysis of patients with follow-up by EUS J Gastroenterol 40 744–51 Occurrence Handle16082592 Occurrence Handle10.1007/s00535-005-1619-7

    Article  PubMed  Google Scholar 

  27. R Salvia C Fernandez-del Castillo C Bassi SP Thayer M Falconi W Mantovani et al. (2004) ArticleTitleMain-duct intraductal papillary mucinous neoplasms of the pancreas: clinical predictors of malignancy and long-term survival following resection Ann Surg 239 678–85 Occurrence Handle15082972 Occurrence Handle10.1097/01.sla.0000124386.54496.15

    Article  PubMed  Google Scholar 

  28. K Yoshizawa H Nagai S Sakurai M Hironaka S Morinaga K Saitoh et al. (2002) ArticleTitleClonality and K-ras mutation analyses of epithelia in intraductal papillary mucinous tumor and mucinous cystic tumor of the pancreas Virchows Arch 441 437–43 Occurrence Handle12447672 Occurrence Handle10.1007/s00428-002-0645-6 Occurrence Handle1:CAS:528:DC%2BD3sXos1emuw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  29. K Z'graggen JA Rivera PA Corris M Pins J Werner C Fernandez-del Castillo et al. (1997) ArticleTitlePrevalence of activating K-ras mutations in the evolutionary stages of neoplasia in intraductal papillary mucinous tumors of the pancreas Ann Surg 226 491–8 Occurrence Handle9351717 Occurrence Handle10.1097/00000658-199710000-00010

    Article  PubMed  Google Scholar 

  30. H Fujii M Inagaki S Kasai N Miyokawa Y Tokusashi E Gabrielson et al. (1997) ArticleTitleGenetic progression and heterogeneity in intraductal papillary–mucinous neoplasms of the pancreas Am J Pathol 151 1447–54 Occurrence Handle9358771 Occurrence Handle1:STN:280:DyaK1c%2FitlKlsQ%3D%3D

    PubMed  CAS  Google Scholar 

  31. K Wada T Takada H Yasuda H Amano M Yoshida M Sugimoto et al. (2004) ArticleTitleDoes “clonal progression” relate to the development of intraductal papillary mucinous tumors of the pancreas? J Gastrointest Surg 8 289–96 Occurrence Handle15019925 Occurrence Handle10.1016/j.gassur.2003.09.027

    Article  PubMed  Google Scholar 

  32. A Kuroda (1988) ArticleTitleRecent progress in clinicopathology of pancreatic tumors Tan to Sui [Biliary Tract and Pancreas] 9 1459–72

    Google Scholar 

  33. S Nakazawa K Yamao M Yamada Y Naito E Kimoto K Inui et al. (1988) ArticleTitleStudy of the classification of mucin-producing cystic tumor of the pancreas Nippon Shokakibyo Gakkai Zasshi 85 924–32 Occurrence Handle2841517 Occurrence Handle1:STN:280:DyaL1czgtFWqtA%3D%3D

    PubMed  CAS  Google Scholar 

  34. P Bernard JY Scoazec M Joubert X Kahn J Le Borgne F Berger et al. (2004) ArticleTitleIntraductal papillary–mucinous tumors of the pancreas: predictive criteria of malignancy according to pathological examination of 53 cases Arch Surg 137 1274–8 Occurrence Handle10.1001/archsurg.137.11.1274

    Article  Google Scholar 

  35. M Kobari S Egawa K Shibuya H Shimamura M Sunamura K Takeda et al. (1999) ArticleTitleIntraductal papillary mucinous tumors of the pancreas comprise 2 clinical subtypes: differences in clinical characteristics and surgical management Arch Surg 134 1131–6 Occurrence Handle10522860 Occurrence Handle10.1001/archsurg.134.10.1131 Occurrence Handle1:STN:280:DyaK1MvltVKqtw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  36. T Nakagohri T Kenmochi O Kainuma Y Tokoro T Asano (1999) ArticleTitleIntraductal papillary mucinous tumors of the pancreas Am J Surg 178 344–7 Occurrence Handle10587197 Occurrence Handle10.1016/S0002-9610(99)00192-0 Occurrence Handle1:STN:280:DC%2BD3c%2Flt1Crsg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  37. B Terris P Ponsot F Paye PR Hammel A Sauvanet G Molas et al. (2000) ArticleTitleIntraductal papillary mucinous tumors of the pancreas confined to secondary ducts show less aggressive pathologic features as compared with those involving the main pancreatic duct Am J Surg Pathol 24 1372–7 Occurrence Handle11023098 Occurrence Handle10.1097/00000478-200010000-00006 Occurrence Handle1:STN:280:DC%2BD3cvmvVagtw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  38. H Irie K Yoshimitsu H Aibe T Tajima A Nishie T Nakayama et al. (2004) ArticleTitleNatural history of pancreatic intraductal papillary mucinous tumor of branch duct type: follow-up study by magnetic resonance cholangiopancreatography J Comput Assist Tomogr 28 117–22 Occurrence Handle14716244 Occurrence Handle10.1097/00004728-200401000-00020

    Article  PubMed  Google Scholar 

  39. NV Adsay K Merati A Andea F Sarkar RH Hruban RE Wilentz et al. (2002) ArticleTitleThe dichotomy in the preinvasive neoplasia to invasive carcinoma sequence in the pancreas: differential expression of MUC1 and MUC2 supports the existence of two separate pathways of carcinogenesis Mod Pathol 15 1087–95 Occurrence Handle12379756 Occurrence Handle10.1097/01.MP.0000028647.98725.8B

    Article  PubMed  Google Scholar 

  40. J Lüttges G Zamboni DS Longnecker G Klöppel (2001) ArticleTitleThe immunohistochemical mucin expression pattern distinguishes different types of intraductal papillary mucinous neoplasms of the pancreas and determines their relationship to mucinous noncystic carcinoma and ductal adenocarcinoma Am J Surg Pathol 25 942–8 Occurrence Handle11420467 Occurrence Handle10.1097/00000478-200107000-00014

    Article  PubMed  Google Scholar 

  41. B Terris S Dubois MP Buisine A Sauvanet P Ruszniewski JP Aubert et al. (2002) ArticleTitleMucin gene expression in intraductal papillary–mucinous pancreatic tumours and related lesions J Pathol 197 632–7 Occurrence Handle12210083 Occurrence Handle10.1002/path.1146 Occurrence Handle1:CAS:528:DC%2BD38Xntleku7w%3D

    Article  PubMed  CAS  Google Scholar 

  42. NV Adsay K Merati O Basturk CA Iacobuzio-Donahue E Levi JD Cheng et al. (2004) ArticleTitlePathologically and biologically distinct types of epithelium in intraductal papillary mucinous neoplasms: delineation of an “intestinal” pathway of carcinogenesis in the pancreas Am J Surg Pathol 28 839–48 Occurrence Handle15223952 Occurrence Handle10.1097/00000478-200407000-00001

    Article  PubMed  Google Scholar 

  43. Furukawa T, Kloppel G, Volkan AN, Albores-Saavedra J, Fukushima N, Horii A, et al. Classification of types of intraductal papillary–mucinous neoplasm of the pancreas: a consensus study. Virchows Arch 2005;1–6

  44. NV Adsay CF Adair CS Heffess DS Klimstra (1996) ArticleTitleIntracuctal oncocytic papillary neoplasms of the pancreas Am J Surg Pathol 20 980–94 Occurrence Handle8712298 Occurrence Handle10.1097/00000478-199608000-00007 Occurrence Handle1:STN:280:DyaK28zgsFaqtQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  45. W Kimura M Makuuchi A Kuroda (1998) ArticleTitleCharacteristics and treatment of mucin-producing tumor of the pancreas Hepatogastroenterology 45 2001–8 Occurrence Handle9951854 Occurrence Handle1:STN:280:DyaK1M7jsFehtw%3D%3D

    PubMed  CAS  Google Scholar 

  46. S Kawamoto KM Horton LP Lawler RH Hruban EK Fishman (2005) ArticleTitleIntraductal papillary mucinous neoplasm of the pancreas: can benign lesions be differentiated from malignant lesions with multidetector CT? Radiographics 25 1451–68 Occurrence Handle16284127 Occurrence Handle10.1148/rg.256055036

    Article  PubMed  Google Scholar 

  47. T Yamaguchi T Baba T Ishihara A Kobayashi K Nakamura H Tadenuma et al. (2005) ArticleTitleLong-term follow-up of intraductal papillary mucinous neoplasm of the pancreas with ultrasonography Clin Gastroenterol Hepatol 3 1136–43 Occurrence Handle16271346 Occurrence Handle10.1016/S1542-3565(05)00756-1

    Article  PubMed  Google Scholar 

  48. JM Winter JL Cameron KD Lillemoe KA Campbell D Chang TS Riall et al. (2006) ArticleTitlePeriampullary and pancreatic incidentaloma: a single institution's experience with an increasingly common diagnosis Ann Surg 243 673–80 Occurrence Handle16633003 Occurrence Handle10.1097/01.sla.0000216763.27673.97

    Article  PubMed  Google Scholar 

  49. C Fernandez-del Castillo J Targarona SP Thayer DW Rattner WR Brugge AL Warshaw (2003) ArticleTitleIncidental pancreatic cysts: clinicopathologic characteristics and comparison with symptomatic patients Arch Surg 138 427–3 Occurrence Handle12686529 Occurrence Handle10.1001/archsurg.138.4.427

    Article  PubMed  Google Scholar 

  50. SJ Handrich DM Hough JG Fletcher MG Sarr (2005) ArticleTitleThe natural history of the incidentally discovered small simple pancreatic cyst: long-term follow-up and clinical implications AJR Am J Roentgenol 184 20–3 Occurrence Handle15615944

    PubMed  Google Scholar 

  51. OW Linton FA Mettler SuffixJr (2003) ArticleTitleNational conference on dose reduction in CT, with an emphasis on pediatric patients AJR Am J Roentgenol 181 321–9 Occurrence Handle12876005

    PubMed  Google Scholar 

  52. KS Spinelli TE Fromwiller RA Daniel JM Kiely A Nakeeb RA Komorowshi et al. (2004) ArticleTitleCystic pancreatic neoplasms: observe or operate Ann Surg 239 651–7 Occurrence Handle15082969 Occurrence Handle10.1097/01.sla.0000124299.57430.ce

    Article  PubMed  Google Scholar 

  53. TA Gordon GP Burleyson JM Tielsch JL Gameron (1995) ArticleTitleThe effects of regionalization on cost and outcome for one general high-risk surgical procedure Ann Surg 221 43–9 Occurrence Handle7826160 Occurrence Handle10.1097/00000658-199501000-00005 Occurrence Handle1:STN:280:DyaK2M7is1Ohtw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  54. TA Gordon HM Bowman JM Tielsch EB Bass GP Burleyson JL Gameron (1998) ArticleTitleStatewide regionalization of pancreaticoduodenectomy and its effect on in-hospital mortality Ann Surg 228 71–8 Occurrence Handle9671069 Occurrence Handle10.1097/00000658-199807000-00011 Occurrence Handle1:STN:280:DyaK1czjsVWntg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  55. M Tanaka S Chari NV Adsay C Fernandez-del Castillo M Falconi M Shimizu et al. (2006) ArticleTitleInternational consensus guidelines for management of intraductal papillary mucinous neoplasms and mucinous cystic neoplasms of the pancreas Pancreatology 6 32 Occurrence Handle10.1159/000090023

    Article  Google Scholar 

  56. KJ Chang P Nguyen RA Erichson TE Durbin KD Katz (1997) ArticleTitleThe clinical utility of endoscopic ultrasound-guided fine-needle aspiration in the diagnosis and staging of pancreatic carcinoma Gastrointest Endosc 45 387–93 Occurrence Handle9165320 Occurrence Handle10.1016/S0016-5107(97)70149-4 Occurrence Handle1:STN:280:DyaK2szgvVSqtg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  57. M Sole C Iglesias G Fernandez-Esparrach L Colomo M Pellise A Gines (2005) ArticleTitleFine-needle aspiration cytology of intraductal papillary mucinous tumors of the pancreas Cancer 105 298–303 Occurrence Handle16015637 Occurrence Handle10.1002/cncr.21242

    Article  PubMed  Google Scholar 

  58. N Sato T Ueki N Fukushima CA Iacobuzio-Donahue CJ Yeo JL Cameron et al. (2002) ArticleTitleAberrant methylation of CpG islands in intraductal papillary mucinous neoplasms of the pancreas Gastroenterology 123 365–72 Occurrence Handle12105864 Occurrence Handle10.1053/gast.2002.34160 Occurrence Handle1:CAS:528:DC%2BD38Xmt1ahs7c%3D

    Article  PubMed  CAS  Google Scholar 

  59. N Sato N Fukushima A Maitra CA Iacobuzio-Donahue NT van Heek JL Cameron et al. (2004) ArticleTitleGene expression profiling identifies genes associated with invasive intraductal papillary mucinous neoplasms of the pancreas Am J Pathol 164 903–14 Occurrence Handle14982844 Occurrence Handle1:CAS:528:DC%2BD2cXitl2jtrc%3D

    PubMed  CAS  Google Scholar 

  60. T Takada H Amano BJ Ammori (2000) ArticleTitleA novel technique for multiple pancreatectomies: removal of unicinate process of the pancreas combined with medial pancreatectomy J Hepatobiliary Pancreat Surg 7 49–52 Occurrence Handle10982591 Occurrence Handle10.1007/s005340050153 Occurrence Handle1:STN:280:DC%2BD3cvntV2itg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  61. A Maitra N Fukushima K Takaori RH Hruban (2005) ArticleTitlePrecursors to invasive pancreatic cancer Adv Anat Pathol 12 81–91 Occurrence Handle15731576 Occurrence Handle10.1097/01.pap.0000155055.14238.25

    Article  PubMed  Google Scholar 

  62. E Cuillerier C Cellier L Palazzo J Deviere P Wind F Rickaert et al. (2000) ArticleTitleOutcome after surgical resection of intraductal papillary and mucinous tumors of the pancreas Am J Gastroenterol 95 441–5 Occurrence Handle10685747 Occurrence Handle10.1111/j.1572-0241.2000.01764.x Occurrence Handle1:STN:280:DC%2BD3c7kvVWrsQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  63. M Inagaki M Maguchi S Kino M Obara A Ishizaki K Onodera et al. (1999) ArticleTitleMucin-producing tumors of the pancreas: clinicopathological features, surgical treatment, and outcome J Hepatobiliary Pancreat Surg 6 281–5 Occurrence Handle10526064 Occurrence Handle10.1007/s005340050119 Occurrence Handle1:STN:280:DyaK1Mvlslehtw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  64. S Milchgrub M Campuzano J Casillas J Albores-Saavedra (1992) ArticleTitleIntraductal carcinoma of the pancreas Cancer 69 651–6 Occurrence Handle1309676 Occurrence Handle10.1002/1097-0142(19920201)69:3<651::AID-CNCR2820690309>3.0.CO;2-# Occurrence Handle1:STN:280:DyaK387htVOitQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  65. T Obara Y Saitoh H Maguchi H Ura S Kitazawa Y Koike et al. (1992) ArticleTitleMulticentric development of pancreatic intraductal carcinoma through atypical papillary hyperplasia Hum Pathol 23 82–5 Occurrence Handle1312058 Occurrence Handle10.1016/0046-8177(92)90018-X Occurrence Handle1:STN:280:DyaK387osVaksQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  66. T Izawa T Obara S Tanno Y Mizukami N Yanagawa Y Kohgo (2001) ArticleTitleClonality and field cancerization in intraductal papillary–mucinous tumors of the pancreas Cancer 92 1807–17 Occurrence Handle11745253 Occurrence Handle10.1002/1097-0142(20011001)92:7<1807::AID-CNCR1697>3.0.CO;2-0 Occurrence Handle1:STN:280:DC%2BD3MnpsFKksQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  67. Y Kitagawa TA Unger S Taylor RA Kozarek LW Traverso (2003) ArticleTitleMucus is a predictor of better prognosis and survival in patients with intraductal papillary mucinous tumor of the pancreas J Gastrointest Surg 7 12–18 Occurrence Handle12559180 Occurrence Handle10.1016/S1091-255X(02)00152-X

    Article  PubMed  Google Scholar 

  68. H Sugiura S Kondo HK Islam K Ito K Ono T Morikawa et al. (2002) ArticleTitleClinicopathologic features and outcomes of intraductal papillary–mucinous tumors of the pancreas Hepatogastroenterology 49 263–7 Occurrence Handle11941971

    PubMed  Google Scholar 

  69. M Sho Y Nakajima H Kanehiro M Hisanaga K Nishio M Nagao et al. (1998) ArticleTitlePattern of recurrence after resection for intraductal papillary mucinous tumors of the pancreas World J Surg 22 874–8 Occurrence Handle9673562 Occurrence Handle10.1007/s002689900485 Occurrence Handle1:STN:280:DyaK1czjvVemsg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  70. TA Sohn CJ Yeo JL Cameron CA Iacobuzio-Donahue RH Hruban KD Lillemoe (2001) ArticleTitleIntraductal papillary mucinous neoplasms of the pancreas: an increasingly recognized clinicopatholoic entity Ann Surg 234 313–21 Occurrence Handle11524584 Occurrence Handle10.1097/00000658-200109000-00005 Occurrence Handle1:STN:280:DC%2BD3MvotVymug%3D%3D

    Article  PubMed  CAS  Google Scholar 

  71. MI Canto M Goggins CJ Yeo C Griffin JE Axilbund K Brune et al. (2004) ArticleTitleScreenng for pancreatic neoplasia in high-risk individuals: an EUS-based approach Clin Gastroenterol Hepatol 2 606–21 Occurrence Handle15224285 Occurrence Handle10.1016/S1542-3565(04)00244-7

    Article  PubMed  Google Scholar 

  72. MI Canto M Goggins RH Hruban EK Fishman JE Axilbund CA Griffin et al. (2006) ArticleTitleScreening for early pancreatic neoplasia in high-risk individuals: a prospective controlled study Clin Gastroenterol Hepatol 4 766–91 Occurrence Handle16682259 Occurrence Handle10.1016/j.cgh.2006.02.005

    Article  PubMed  Google Scholar 

  73. GH Su RH Hruban GS Bova M Goggins RK Bansal DT Tang et al. (1999) ArticleTitleGermline and somatic mutations of the STK11/LKB1 Peutz–Jeghers gene in pancreatic and biliary cancers Am J Pathol 154 1835–40 Occurrence Handle10362809 Occurrence Handle1:CAS:528:DyaK1MXjvFGrtL0%3D

    PubMed  CAS  Google Scholar 

  74. F Maire P Hammel B Terris S Olschwang D O'Toole A Sauvanet et al. (2002) ArticleTitleIntraductal papillary and mucinous pancreatic tumour: a new extracolonic tumour in familial adenomatous polyposis Gut 51 446–9 Occurrence Handle12171972 Occurrence Handle10.1136/gut.51.3.446 Occurrence Handle1:STN:280:DC%2BD38vhvVSktQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  75. M Sugiyama Y Atomi (1999) ArticleTitleExtrapancreatic neoplasms occur with unusual frequency in patients with intraductal papillary mucinous tumors of the pancreas Am J Gastroenterol 94 470–3 Occurrence Handle10022648 Occurrence Handle10.1111/j.1572-0241.1999.879_h.x Occurrence Handle1:STN:280:DyaK1M7ksFantA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  76. K Yamaguchi K Yokohata H Noshiro K Chijiiwa M Tanaka (2000) ArticleTitleMucinous cystic neoplasm of the pancreas or intraductal papillary–mucinous tumour of the pancreas Eur J Surg 166 141–8 Occurrence Handle10724492 Occurrence Handle1:STN:280:DC%2BD3c7oslSrtQ%3D%3D Occurrence Handle10.1080/110241500750009492

    Article  PubMed  CAS  Google Scholar 

  77. JE Axilbund KA Brune MI Canto BC Brehon LD Wroblewski CA Griffin (2005) ArticleTitlePatient perspective on the values of genetic counseling for familial pancreatic cancer Hered Cancer Clin Pract 3 115–22

    Google Scholar 

  78. RH Hruban NV Adsay J Albores-Saavedra C Compton E Garrett SN Goodman et al. (2001) ArticleTitlePancreatic intraepithelial neoplasia: a new nomenclature and classification system for pancreatic duct lesions Am J Surg Pathol 25 579–86 Occurrence Handle11342768 Occurrence Handle10.1097/00000478-200105000-00003 Occurrence Handle1:STN:280:DC%2BD3M3ktV2kuw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  79. RH Hruban K Takaori DS Klimstra NV Adsay J Albores-Saavedra AV Biankin et al. (2004) ArticleTitleAn illustrated consensus on the classification of pancreatic intraepithelial neoplasia and intraductal papillary mucinous neoplasms Am J Surg Pathol 28 977–87 Occurrence Handle15252303 Occurrence Handle10.1097/01.pas.0000126675.59108.80

    Article  PubMed  Google Scholar 

  80. SPL Hulst (1905) ArticleTitleZur kenntnis der Genese des Adenokarzinoms und Karzinoms des Pankreas Virchows Arch (B) 180 288–316

    Google Scholar 

  81. RH Hruban M Goggins JL Parsons SE Kern (2000) ArticleTitleProgression model for pancreatic cancer Clin Cancer Res 6 2969–72 Occurrence Handle10955772 Occurrence Handle1:STN:280:DC%2BD3M%2FmtVWisg%3D%3D

    PubMed  CAS  Google Scholar 

  82. DJ Brat KD Lillemoe CJ Yeo PB Warfield RH Hruban (1998) ArticleTitleProgression of pancreatic intraductal neoplasias to infiltrating adenocarcinoma of the pancreas Am J Surg Pathol 122 163–9 Occurrence Handle10.1097/00000478-199802000-00003

    Article  Google Scholar 

  83. E Brockie A Anand J Albores-Saavedra (1998) ArticleTitleProgression of atypical ductal hyperplasia/carcinoma in situ of the pancreas to invasive adenocarcinoma Ann Diagn Pathol 2 286–92 Occurrence Handle9845751 Occurrence Handle10.1016/S1092-9134(98)80020-8 Occurrence Handle1:STN:280:DyaK1M%2Fmtl2juw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  84. N Fukushima N Sato T Ueki C Rosty KM Walter RE Wilentz et al. (2002) ArticleTitleAberrant methylation of preproenkephalin and p16 genes in pancreatic intraepithelial neoplasia and pancreatic ductal adenocarcinoma Am J Pathol 160 1573–81 Occurrence Handle12000709 Occurrence Handle1:CAS:528:DC%2BD38XksVKrtL4%3D

    PubMed  CAS  Google Scholar 

  85. K Takaori Y Kobashi S Matsusue K Matsui T Yamamoto (2003) ArticleTitleClinicopathological features of pancreatic intraepithelial neoplasias and their relationship to intraductal papillary–mucinous tumors J Hepatobiliary Pancreat Surg 10 125–36 Occurrence Handle14505145 Occurrence Handle10.1007/s00534-003-0756-8

    Article  PubMed  Google Scholar 

  86. K Brune T Abe MI Canto L O'Malley AP Klein A Maitra et al. (2006) ArticleTitleMultifocal neoplastic precusor lesions associated with lobular atrophy of the pancreas in patients having a strong family history of pancreatic cancer Am J Surg Pathol 30 1067–76 Occurrence Handle16931950

    PubMed  Google Scholar 

  87. DD Dershaw A Abramson DW Kinne (1989) ArticleTitleDuctal carcinoma in situ: mammographic findings and clinical implications Radiology 170 411–15 Occurrence Handle2536185 Occurrence Handle1:STN:280:DyaL1M%2FpvFKnsw%3D%3D

    PubMed  CAS  Google Scholar 

  88. Detlefsen S, Sipos B, Feyerabend B, Klöppel G. Pancreatic fibrosis associated with age and ductal papillary hyperplasia. Virchows Arch 2005;1–6

  89. K Takaori S Matsusue T Fujikawa Y Kobashi T Ito Y Matsuo et al. (1998) ArticleTitleCarcinoma in situ of the pancreas associated with localized fibrosis: a clue to early detection of neoplastic lesions arising from pancreatic ducts Pancreas 17 102–5 Occurrence Handle9667529 Occurrence Handle10.1097/00006676-199807000-00015 Occurrence Handle1:STN:280:DyaK1czjtVWjsQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  90. C Shi SH Eshleman D Jones N Fukushima L Hua AR Parker et al. (2004) ArticleTitleLigAmp for sensitive detection of single-nucleotide differences Nat Methods 1 141–7 Occurrence Handle15782177 Occurrence Handle10.1038/nmeth713 Occurrence Handle1:CAS:528:DC%2BD2MXisVGhu7o%3D

    Article  PubMed  CAS  Google Scholar 

  91. H Matsubayashi M Canto N Sato AP Klein T Abe K Yamashita et al. (2006) ArticleTitleDNA methylation alterations in the pancreatic juice of patients with suspected pancreatic disease Cancer Res 66 1208–17 Occurrence Handle16424060 Occurrence Handle10.1158/0008-5472.CAN-05-2664 Occurrence Handle1:CAS:528:DC%2BD28XlsFOnuw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  92. T Matsumoto S Hirano K Yada Y Himeno K Shibata M Aramaki et al. (2005) ArticleTitleSafety and efficacy of laparoscopic distal pancreatectomy for the treatment of pancreatic disease J Hepatobiliary Pancreat Surg 12 65–70 Occurrence Handle15754103 Occurrence Handle10.1007/s00534-004-0930-7

    Article  PubMed  Google Scholar 

  93. CP Morrison FG Court BD Teague MS Metcalfe SA Wemyss-Holden M Texler et al. (2005) ArticleTitleEndoscopic perductal electrolytic ablation of the pancreas: experimental studies of morbidity and mortality Dig Dis 23 83–91 Occurrence Handle15920329 Occurrence Handle10.1159/000084730 Occurrence Handle1:STN:280:DC%2BD2M3ns1CmsQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  94. A Maitra NV Adsay P Argani CA Iacobuzio-Donahue A De Marzo JL Cameron et al. (2003) ArticleTitleMulticomponent analysis of the pancreatic adenocarcinoma progression model using a pancreatic intraepithelial neoplasia tissue microarray Mod Pathol 16 902–12 Occurrence Handle13679454 Occurrence Handle10.1097/01.MP.0000086072.56290.FB

    Article  PubMed  Google Scholar 

  95. SR Hustinx LM Leoni CJ Yeo PN Brown M Goggins SE Kern et al. (2005) ArticleTitleConcordant loss of MTAP and p16/CDKN2A expression in pancreatic intraepithelial neoplasia: evidence of homozygous deletion in a noninvasive precursor lesion Mod Pathol 18 959–63 Occurrence Handle15832197 Occurrence Handle10.1038/modpathol.3800377 Occurrence Handle1:CAS:528:DC%2BD2MXltlCitL8%3D

    Article  PubMed  CAS  Google Scholar 

  96. A Maitra R Ashfaq CR Gunn A Rahman CJ Yeo TA Sohn et al. (2002) ArticleTitleCyclooxygenase 2 expression in pancreatic adenocarcinoma and pancreatic intraepithelial neoplasia: an immunohistochemical analysis with automated cellular imaging Am J Clin Pathol 118 194–201 Occurrence Handle12162677 Occurrence Handle10.1309/TPG4-CK1C-9V8V-8AWC Occurrence Handle1:CAS:528:DC%2BD38XmsVWrsLw%3D

    Article  PubMed  CAS  Google Scholar 

  97. NB Prasad AV Biankin N Fukushima A Maitra S Dhara AG Elkahloun et al. (2005) ArticleTitleGene expression profiles in pancreatic intraepithelial neoplasia reflect the effects of Hedgehog signaling on pancreatic ductal epithelial cells Cancer Res 65 1619–26 Occurrence Handle15753353 Occurrence Handle10.1158/0008-5472.CAN-04-1413 Occurrence Handle1:CAS:528:DC%2BD2MXitVOjs74%3D

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins Medical Institutions, Weinberg Room 2242, 401 North Broadway, Baltimore, MD, USA

    Ralph H. Hruban, Kieran Brune, Scott E. Kern & Michael Goggins

  2. Department of Oncology, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins Medical Institutions, Weinberg Room 2242, 401 North Broadway, Baltimore, MD, USA

    Ralph H. Hruban, Marcia Canto & Scott E. Kern

  3. Department of General and Gastroenterological Surgery, Osaka Medical College, Osaka, Japan

    Kyoichi Takaori

  4. Department of Medicine, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins Medical Institutions, Weinberg Room 2242, 401 North Broadway, Baltimore, MD, USA

    Marcia Canto & Michael Goggins

  5. Department of Radiology, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins Medical Institutions, Weinberg Room 2242, 401 North Broadway, Baltimore, MD, USA

    Elliot K. Fishman

  6. Department of Surgery, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins Medical Institutions, Weinberg Room 2242, 401 North Broadway, Baltimore, MD, USA

    Kurtis Campbell

Authors
  1. Ralph H. Hruban
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kyoichi Takaori
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marcia Canto
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Elliot K. Fishman
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kurtis Campbell
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kieran Brune
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Scott E. Kern
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Michael Goggins
    View author publications

    You can also search for this author in PubMed Google Scholar

About this article

Cite this article

Hruban, R., Takaori, K., Canto, M. et al. Clinical importance of precursor lesions in the pancreas. J Hepatobiliary Pancreat Surg 14, 255–263 (2007). https://doi.org/10.1007/s00534-006-1170-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00534-006-1170-9

Key words

Search

Navigation