title: Update on pancreatic intraepithelial neoplasia.
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.
authors.affiliation: The Sol Goldman Pancreatic Cancer Research Center, the Departments of Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore, MD, USA. rhruban@jhmi.edu
authors.forename: Ralph H
authors.initials: RH
authors.lastname: Hruban
authors.forename: Anirban
authors.initials: A
authors.lastname: Maitra
authors.forename: Michael
authors.initials: M
authors.lastname: Goggins
references.citation: Proc Natl Acad Sci U S A. 2007 Mar 13;104(11):4437-42
references.pmid: 17360542
references.citation: Mod Pathol. 2003 Sep;16(9):902-12
references.pmid: 13679454
references.citation: Cancer Res. 1993 Mar 1;53(5):953-6
references.pmid: 8439969
references.citation: Neoplasia. 2005 Jan;7(1):17-23
references.pmid: 15720814
references.citation: Genes Dev. 2006 Nov 15;20(22):3130-46
references.pmid: 17114584
references.citation: Am J Pathol. 2002 Nov;161(5):1541-7
references.pmid: 12414502
references.citation: Gastroenterology. 2002 Oct;123(4):1052-60
references.pmid: 12360467
references.citation: Cancer Cell. 2007 Mar;11(3):211-3
references.pmid: 17349578
references.citation: Am J Surg Pathol. 1998 Feb;22(2):163-9
references.pmid: 9500216
references.citation: Mol Imaging. 2007 Mar-Apr;6(2):131-9
references.pmid: 17445507
references.citation: Mod Pathol. 2003 Oct;16(10):996-1006
references.pmid: 14559982
references.citation: Clin Gastroenterol Hepatol. 2004 Jul;2(7):606-21
references.pmid: 15224285
references.citation: Am J Pathol. 2000 Jul;157(1):83-92
references.pmid: 10880379
references.citation: Nat Genet. 1994 Sep;8(1):27-32
references.pmid: 7726912
references.citation: Mol Cell Biol. 2002 Jan;22(2):635-43
references.pmid: 11756558
references.citation: Cancer Res. 2006 Jan 15;66(2):1208-17
references.pmid: 16424060
references.citation: Cancer. 1979 Apr;43(4):1418-28
references.pmid: 445339
references.citation: Am J Surg Pathol. 2001 May;25(5):579-86
references.pmid: 11342768
references.citation: Gastroenterology. 2006 Dec;131(6):1844-55
references.pmid: 17087933
references.citation: Cancer Res. 2004 Apr 1;64(7):2634-8
references.pmid: 15059921
references.citation: Clin Gastroenterol Hepatol. 2006 Jun;4(6):766-81; quiz 665
references.pmid: 16682259
references.citation: Am J Surg Pathol. 2004 Aug;28(8):977-87
references.pmid: 15252303
references.citation: Am J Pathol. 2000 Jun;156(6):2123-33
references.pmid: 10854233
references.citation: Cancer Res. 1997 Jun 1;57(11):2140-3
references.pmid: 9187111
references.citation: Cancer Cell. 2005 May;7(5):469-83
references.pmid: 15894267
references.citation: Am J Clin Pathol. 2002 May;117(5):791-6
references.pmid: 12090430
references.citation: Am J Pathol. 2000 May;156(5):1767-71
references.pmid: 10793087
references.citation: JAMA. 2000 Oct 18;284(15):1954-61
references.pmid: 11035892
references.citation: Cancer Res. 2003 Jul 1;63(13):3735-42
references.pmid: 12839967
references.citation: Am J Pathol. 2001 May;158(5):1677-83
references.pmid: 11337365
references.citation: Am J Surg Pathol. 2006 Sep;30(9):1067-76
references.pmid: 16931950
references.citation: Cancer Res. 2000 Apr 1;60(7):1835-9
references.pmid: 10766168
references.citation: Cancer Res. 2007 Jan 15;67(2):433-6
references.pmid: 17234748
references.citation: Cancer Res. 1994 Jul 1;54(13):3568-73
references.pmid: 8012983
references.citation: Nat Methods. 2004 Nov;1(2):141-7
references.pmid: 15782177
references.citation: Virchows Arch. 2005 Nov;447(5):800-5
references.pmid: 16021508
references.citation: Cancer Res. 2005 Mar 1;65(5):1619-26
references.pmid: 15753353
references.citation: Am J Surg Pathol. 2001 Aug;25(8):1047-53
references.pmid: 11474289
references.citation: Cancer Cell. 2007 Mar;11(3):291-302
references.pmid: 17349585
references.citation: Am J Pathol. 2002 May;160(5):1573-81
references.pmid: 12000709
references.citation: Cancer Cell. 2007 Mar;11(3):229-43
references.pmid: 17349581
references.citation: J Hepatobiliary Pancreat Surg. 2006;13(4):286-95
references.pmid: 16858539
references.citation: Clin Cancer Res. 2006 Sep 15;12(18):5411-6
references.pmid: 17000674
references.citation: Clin Cancer Res. 2006 Sep 15;12(18):5417-22
references.pmid: 17000675
references.citation: Cancer Cell. 2005 Sep;8(3):185-95
references.pmid: 16169464
references.citation: Cancer. 1999 Apr 15;85(8):1703-10
references.pmid: 10223563
references.citation: Gastroenterology. 2004 Jun;126(7):1674-80
references.pmid: 15188160
references.citation: Science. 1996 Jan 19;271(5247):350-3
references.pmid: 8553070
references.citation: Cancer Res. 1998 Oct 15;58(20):4740-4
references.pmid: 9788631
references.citation: Cancer Res. 2006 Jan 1;66(1):242-7
references.pmid: 16397237
references.citation: Cancer Res. 1976 Jul;36(7 PT 2):2690-8
references.pmid: 1277176
references.citation: J Natl Cancer Inst. 2003 Apr 16;95(8):622-5
references.pmid: 12697855
references.citation: Am J Surg Pathol. 2006 Jun;30(6):754-9
references.pmid: 16723855
references.citation: Cancer Epidemiol Biomarkers Prev. 1998 Jun;7(6):515-21
references.pmid: 9641496
references.citation: Pancreas. 2003 Apr;26(3):e48-54
references.pmid: 12657964
references.citation: Am J Surg Pathol. 2003 Dec;27(12):1495-501
references.pmid: 14657708
references.citation: Mod Pathol. 2002 Oct;15(10):1087-95
references.pmid: 12379756
references.citation: Am J Clin Pathol. 2002 Aug;118(2):194-201
references.pmid: 12162677
references.citation: Ann Diagn Pathol. 1998 Oct;2(5):286-92
references.pmid: 9845751
references.citation: J Natl Cancer Inst. 1997 Mar 19;89(6):442-6
references.pmid: 9091646
references.citation: Genes Dev. 2003 Dec 15;17(24):3112-26
references.pmid: 14681207
references.citation: Cancer Biol Ther. 2002 May-Jun;1(3):293-6
references.pmid: 12432281
references.citation: Cancer Biol Ther. 2003 Jan-Feb;2(1):78-83
references.pmid: 12673124
references.citation: J Hepatobiliary Pancreat Surg. 2007;14(3):243-54
references.pmid: 17520199
references.citation: Cancer Res. 2006 Jan 1;66(1):95-106
references.pmid: 16397221
references.citation: Cancer Res. 2007 Aug 1;67(15):7068-71
references.pmid: 17652141
references.citation: N Engl J Med. 2005 Oct 27;353(17):1784-92
references.pmid: 16251534
references.citation: Gastroenterology. 1996 Jan;110(1):227-31
references.pmid: 8536861
references.citation: Cancer Cell. 2003 Dec;4(6):437-50
references.pmid: 14706336
references.citation: Cancer Res. 2003 May 1;63(9):2005-9
references.pmid: 12727809
references.citation: Am J Pathol. 2007 Jul;171(1):263-73
references.pmid: 17591971
references.citation: Clin Cancer Res. 2000 Aug;6(8):2969-72
references.pmid: 10955772
references.citation: Cancer Res. 2000 Apr 1;60(7):2002-6
references.pmid: 10766191
references.citation: Cancer Res. 1997 Aug 1;57(15):3126-30
references.pmid: 9242437
references.citation: Am J Surg Pathol. 2007 Apr;31(4):645-6
references.pmid: 17414117
references.citation: Int J Cancer. 2006 Jan 15;118(2):405-11
references.pmid: 16052519
references.citation: Ann Intern Med. 1999 Aug 17;131(4):247-55
references.pmid: 10454945