The prevalence and clinicopathological characteristics of high-grade pancreatic intraepithelial neoplasia autopsy study evaluating the entire pancreatic parenchyma

Yoko Matsuda, Toru Furukawa, Shinichi Yachida, Makoto Nishimura, Atsuko Seki, Keisuke Nonaka, Junko Aida, Kaiyo Takubo, Toshiyuki Ishiwata, Wataru Kimura, Tomio Arai, Mari Mino-Kenudson

Research output: Contribution to journalArticle

20 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)658-664
Number of pages7
JournalPancreas
Volume46
Issue number5
DOIs
Publication statusPublished - 2017 Jan 1
Externally publishedYes

Keywords

  • Carcinoma in situ
  • Dysplasia
  • Fibrosis
  • PanIN
  • Pancreas

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology

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    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. (2017). The prevalence and clinicopathological characteristics of high-grade pancreatic intraepithelial neoplasia autopsy study evaluating the entire pancreatic parenchyma. Pancreas, 46(5), 658-664. https://doi.org/10.1097/MPA.0000000000000786