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Int J Clin Exp Pathol 1(4):306-316;2008

Review Article
Update on Pancreatic Intraepithelial Neoplasia

Ralph Hruban, Anirban Maitra and Michael Goggins

The Sol Goldman Pancreatic Cancer Research Center, the Departments of Pathology, Oncology and Medicine, and the Institute for Genetic
Medicine, the Johns Hopkins Medical Institutions, Baltimore, Maryland

Received 28 Sept 2007; available online 1 January 2008

Abstract: Pancreatic intraepithelial neoplasia (PanIN) is a histologically well-defined precursor to invasive ductal adenocarcinoma of the
pancreas. PanINs are remarkably common lesions, particularly in the elderly population. Molecular studies have helped establish the
progression of PanIN to invasive cancer, and recently genetically engineered mouse models have been generated that recapitulate the entire
spectrum of lesions from precursor to invasive pancreatic cancer. Some PanIN lesions produce lobulocentric atrophy of the pancreatic
parenchyma, and, when multifocal, this lobulocentric atrophy may be detectable using currently available imaging techniques such as
endoscopic ultrasound. The association of acinar-ductal metaplasia with PanIN lesions has led some to hypothesize that PanINs develop from
acinar cells that undergo acinar-ductal metaplasia.(IJCEP709011).

Key Words: Pancreatic cancer, intraepithelial neoplasm, metaplasia, genetics, epigenetics

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Address all correspondence to: Ralph Hruban, M.D., The Sol Goldman Pancreatic Cancer Research Center, Weinberg 2242, The Johns
Hopkins Medical Institutions, 401 North Broadway, Baltimore, MD 21231. Phone:  410-955-9132, Fax: 410-955-0115,