The Prevalence and Clinicopathological Characteristics of High-Grade Pancreatic Intraepithelial Neoplasia: Autopsy Study Evaluating the Entire Pancreatic Parenchyma
Abstract
OBJECTIVE: We sought to identify clinicopathological characteristics of high-grade pancreatic intraepithelial neoplasia (PanIN)/carcinoma in situ to facilitate screening for pancreatic ductal adenocarcinoma. METHODS: We evaluated PanIN lesions in 173 consecutive autopsy cases with no evidence of pancreatic ductal adenocarcinoma and/or intraductal papillary mucinous neoplasm (mean age, 80.5 years) by submitting the entire pancreas for microscopic examination. RESULTS: PanIN-3 was found in 4% of examined cases, whereas PanIN-1 and PanIN-2 were present in 77% and 28%, respectively. PanIN-3 was more frequently identified in patients with diabetes mellitus and/or older age. PanIN-3 lesions were always multifocal, and the number of PanIN-3 foci was positively associated with those of PanIN-1 or PanIN-2. PanIN-3 was located more frequently in the pancreatic body and tail than in the head and predominantly involved small interlobular/intralobular ducts rather than the main duct. Notably, 71% of pancreata with PanIN-3 showed cystic changes in PanIN-3 and lower grade PanIN lesions. PanIN-3 was also accompanied by higher grade extralobular fibrosis. CONCLUSIONS: We found that 4% of the examined pancreata harbored PanIN-3 lesions that were associated with several unique clinicopathological features. The cystic change along with fibrotic pancreatic parenchyma may be detected by imaging studies such as endoscopic ultrasound.
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- Authors
- Matsuda, Y., Furukawa, T., Yachida, S., Nishimura, M., Seki, A., Nonaka, K., Aida, J., Takubo, K., Ishiwata, T., Kimura, W., Arai, T., & Mino-Kenudson, M.
- Affiliations
- Yamagata University (JP)
- Tokyo Women's Medical University (JP)
- National Cancer Center Research Institute (JP)
- Tokyo Metropolitan Geriatric Hospital (JP)
- Tokyo Metropolitan Institute of Gerontology (JP)
- Harvard University (US)
- Corresponding author
- Matsuda, Yoko
- Seki, Atsuko
- Nonaka, Keisuke
- Arai, Tomio
- ORCID
- Venue
- Pancreas
- Published
- 2017-05
- Volume
- 46
- Issue
- 5
- Pages
- 658-664
- ISSN
- 0885-3177 (ISSN-L)
- OpenAlex
- W2588514429
- Cited by
- 89
- References
- 2
- Citations by year
- 2026: 10 · 2025: 10 · 2024: 14 · 2023: 13 · 2022: 5 · 2021: 15 · 2020: 5 · 2019: 9 · 2018: 4 · 2017: 4
- FWCI
- 2.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pancreas (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Japan Society for the Promotion of Science (16KT0125)
- Topics
- Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
- Health Sciences › Medicine › Surgery › Pancreatitis Pathology and Treatment
- Health Sciences › Medicine › Epidemiology › Neuroendocrine Tumor Research Advances
- Keywords
- pancreatic intraepithelial neoplasia, clinicopathological features, cystic change, diabetes mellitus, endoscopic ultrasound
- MeSH terms
- Adult, Aged, Aged, 80 and over, Autopsy, Carcinoma in Situ, Female, Humans, Male, Middle Aged, Pancreas, Pancreatic Neoplasms, Precancerous Conditions, Incidence, Prevalence, Carcinoma, Pancreatic Ductal, Neoplasm Grading
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