title: Pancreatic intraepithelial neoplasia in patients with intraductal papillary mucinous neoplasms: the interest of endoscopic ultrasonography.
abstract: OBJECTIVE
  Intraductal papillary mucinous neoplasms (IPMNs) and pancreatic intraepithelial neoplasia (PanIN) are both precancerous lesions. Papillary mucinous neoplasms have been described in patients with IPMN, but their relationship is still poorly understood. The aims of this study were to look for PanIN lesions in patients operated on for IPMN and to search for correlations between endoscopic ultrasonography(EUS) features and pathologic findings.
  
  
  METHODS
  Endoscopic ultrasonography was preoperatively performed in all patients with IPMN consecutively operated on in our center. Endoscopic ultrasonography features were prospectively compared with pathologic data from surgical specimen.
  
  
  RESULTS
  Forty patients underwent resection for benign (52.5%) or malignant (47.5%) IPMN. Pancreatic intraepithelial neoplasia lesions were observed in 78% of cases (PanIN-3 in 19% of patients). PanIN-3 lesions were observed in 11% and 26% of patients with benign and malignant IPMN, respectively. Endoscopic ultrasonography changes(microcysts and/or hyperechoic foci) corresponded to PanIN lesions in 83% of cases. Endoscopic ultrasonography detected 69% of patients with PanIN lesions and 57% of those with panIN-3 lesions.
  
  
  CONCLUSIONS
  Pancreatic intraepithelial neoplasia lesions are very frequently associated with IPMN, and 19% of patients with IPMN had PanIN-3 lesions. In two thirds of patients, EUS can detect minimal changes in the pancreas corresponding to PanIN lesions.
authors.forename: Frédérique
authors.initials: F
authors.lastname: Maire
authors.forename: Anne
authors.initials: A
authors.lastname: Couvelard
authors.forename: Laurent
authors.initials: L
authors.lastname: Palazzo
authors.forename: Alain
authors.initials: A
authors.lastname: Aubert
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Vullierme
authors.forename: Vinciane
authors.initials: V
authors.lastname: Rebours
authors.forename: Pascal
authors.initials: P
authors.lastname: Hammel
authors.forename: Alain
authors.initials: A
authors.lastname: Sauvanet
authors.forename: Philippe
authors.initials: P
authors.lastname: Levy
authors.forename: Philippe
authors.initials: P
authors.lastname: Ruszniewski
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis* / Q000601:surgery; D000231:Adenocarcinoma, Papillary / Q000175:diagnosis* / Q000601:surgery; D000328:Adult; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis* / Q000601:surgery; D019160:Endosonography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000601:surgery; D011230:Precancerous Conditions / Q000175:diagnosis* / Q000601:surgery; D011379:Prognosis; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed