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High Grade Pancreatic Intraepithelial Neoplasia

MedGen UID:
459371
•Concept ID:
C2987145
•
Neoplastic Process
Synonyms: Grade 3 Pancreatic Intraepithelial Neoplasia; Grade III Pancreatic Intraepithelial Neoplasia; High Grade PanIN; High-Grade Pancreatic Intraepithelial Neoplasia; High-Grade PanIN; Pancreatic Intraepithelial Neoplasia-3

Definition

A pancreatic epithelial neoplasia characterized by the presence of papillary and rarely flat architectural patterns with formation of cribriform patterns and luminal necrosis. Severe dysplasia is present. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVHigh Grade Pancreatic Intraepithelial Neoplasia

Professional guidelines

PubMed

Diagnostic Yield From Screening Asymptomatic Individuals at High Risk for Pancreatic Cancer: A Meta-analysis of Cohort Studies.
Corral JE, Mareth KF, Riegert-Johnson DL, Das A, Wallace MB
Clin Gastroenterol Hepatol 2019 Jan;17(1):41-53. Epub 2018 Jun 30 doi: 10.1016/j.cgh.2018.04.065. PMID: 29775792

Recent clinical studies

Etiology

Pancreatic Cancer Screening for At-Risk Individuals (Pancreas Scan Study): Yield, Harms, and Outcomes From a Prospective Multicenter Study.
Shah I, Silva-Santisteban A, Germansky KA, Trindade A, Raphael KL, Kushnir V, Pawa R, Mishra G, Anastasiou J, Inamdar S, Tharian B, Bilal M, Sawhney MS
Am J Gastroenterol 2023 Sep 1;118(9):1664-1670. Epub 2023 May 4 doi: 10.14309/ajg.0000000000002314. PMID: 37141538
mAb Das-1 identifies pancreatic ductal adenocarcinoma and high-grade pancreatic intraepithelial neoplasia with high accuracy.
Das KK, Brown JW, Fernandez Del-Castillo C, Huynh T, Mills JC, Matsuda Y, Das KM, Mino-Kenudson M
Hum Pathol 2021 May;111:36-44. Epub 2021 Jan 30 doi: 10.1016/j.humpath.2021.01.003. PMID: 33524436Free PMC Article
Pancreatic cancer screening.
Lindquist CM, Miller FH, Hammond NA, Nikolaidis P
Abdom Radiol (NY) 2018 Feb;43(2):264-272. doi: 10.1007/s00261-017-1308-z. PMID: 28840303
High-grade pancreatic intraepithelial lesions: prevalence and implications in pancreatic neoplasia.
Park JR, Li F, Oza VM, Sklaw BC, Cronley KM, Wellner M, Swanson B, Krishna SG
Hepatobiliary Pancreat Dis Int 2017 Apr;16(2):202-208. doi: 10.1016/s1499-3872(16)60186-8. PMID: 28381386
New strategies for the early detection of pancreatic cancer.
Petrone MC, Arcidiacono PG
Expert Rev Gastroenterol Hepatol 2016;10(2):157-9. Epub 2015 Dec 14 doi: 10.1586/17474124.2016.1122521. PMID: 26582179

Diagnosis

Pancreatic Cancer Screening for At-Risk Individuals (Pancreas Scan Study): Yield, Harms, and Outcomes From a Prospective Multicenter Study.
Shah I, Silva-Santisteban A, Germansky KA, Trindade A, Raphael KL, Kushnir V, Pawa R, Mishra G, Anastasiou J, Inamdar S, Tharian B, Bilal M, Sawhney MS
Am J Gastroenterol 2023 Sep 1;118(9):1664-1670. Epub 2023 May 4 doi: 10.14309/ajg.0000000000002314. PMID: 37141538
Endoscopic approach in the diagnosis of high-grade pancreatic intraepithelial neoplasia.
Hanada K, Shimizu A, Kurihara K, Ikeda M, Yamamoto T, Okuda Y, Tazuma S
Dig Endosc 2022 Jul;34(5):927-937. Epub 2022 Feb 14 doi: 10.1111/den.14240. PMID: 35165942
mAb Das-1 identifies pancreatic ductal adenocarcinoma and high-grade pancreatic intraepithelial neoplasia with high accuracy.
Das KK, Brown JW, Fernandez Del-Castillo C, Huynh T, Mills JC, Matsuda Y, Das KM, Mino-Kenudson M
Hum Pathol 2021 May;111:36-44. Epub 2021 Jan 30 doi: 10.1016/j.humpath.2021.01.003. PMID: 33524436Free PMC Article
High-risk lesions in the remnant pancreas: fate of the remnant pancreas after pancreatic resection for pancreatic cancer and intraductal papillary mucinous neoplasms.
Miyasaka Y, Ohtsuka T, Matsuda R, Mori Y, Nakata K, Ohuchida K, Nakamura M
Surg Today 2020 Aug;50(8):832-840. Epub 2019 Jul 25 doi: 10.1007/s00595-019-01852-3. PMID: 31346809
New strategies for the early detection of pancreatic cancer.
Petrone MC, Arcidiacono PG
Expert Rev Gastroenterol Hepatol 2016;10(2):157-9. Epub 2015 Dec 14 doi: 10.1586/17474124.2016.1122521. PMID: 26582179

Therapy

Endoscopic Ultrasound Can Differentiate High-Grade Pancreatic Intraepithelial Neoplasia, Small Pancreatic Ductal Adenocarcinoma, and Benign Stenosis.
Sagami R, Yamao K, Minami R, Nakahodo J, Akiyama H, Nishikiori H, Mizukami K, Yamao K, Bhatia V, Amano Y, Murakami K
Gut Liver 2024 Mar 15;18(2):338-347. Epub 2023 May 11 doi: 10.5009/gnl220521. PMID: 37165770Free PMC Article
Endoscopic approach in the diagnosis of high-grade pancreatic intraepithelial neoplasia.
Hanada K, Shimizu A, Kurihara K, Ikeda M, Yamamoto T, Okuda Y, Tazuma S
Dig Endosc 2022 Jul;34(5):927-937. Epub 2022 Feb 14 doi: 10.1111/den.14240. PMID: 35165942
miRNA-1290 Promotes Aggressiveness in Pancreatic Ductal Adenocarcinoma by Targeting IKK1.
Ta N, Huang X, Zheng K, Zhang Y, Gao Y, Deng L, Zhang B, Jiang H, Zheng J
Cell Physiol Biochem 2018;51(2):711-728. Epub 2018 Nov 21 doi: 10.1159/000495328. PMID: 30463064

Prognosis

Focal pancreatic parenchyma atrophy is a harbinger of pancreatic cancer and a clue to the intraductal spreading subtype.
Nakahodo J, Kikuyama M, Fukumura Y, Horiguchi SI, Chiba K, Tabata H, Suzuki M, Kamisawa T
Pancreatology 2022 Dec;22(8):1148-1158. Epub 2022 Oct 17 doi: 10.1016/j.pan.2022.10.003. PMID: 36273992
Endoscopic approach in the diagnosis of high-grade pancreatic intraepithelial neoplasia.
Hanada K, Shimizu A, Kurihara K, Ikeda M, Yamamoto T, Okuda Y, Tazuma S
Dig Endosc 2022 Jul;34(5):927-937. Epub 2022 Feb 14 doi: 10.1111/den.14240. PMID: 35165942
High-risk lesions in the remnant pancreas: fate of the remnant pancreas after pancreatic resection for pancreatic cancer and intraductal papillary mucinous neoplasms.
Miyasaka Y, Ohtsuka T, Matsuda R, Mori Y, Nakata K, Ohuchida K, Nakamura M
Surg Today 2020 Aug;50(8):832-840. Epub 2019 Jul 25 doi: 10.1007/s00595-019-01852-3. PMID: 31346809
High-grade pancreatic intraepithelial lesions: prevalence and implications in pancreatic neoplasia.
Park JR, Li F, Oza VM, Sklaw BC, Cronley KM, Wellner M, Swanson B, Krishna SG
Hepatobiliary Pancreat Dis Int 2017 Apr;16(2):202-208. doi: 10.1016/s1499-3872(16)60186-8. PMID: 28381386
New strategies for the early detection of pancreatic cancer.
Petrone MC, Arcidiacono PG
Expert Rev Gastroenterol Hepatol 2016;10(2):157-9. Epub 2015 Dec 14 doi: 10.1586/17474124.2016.1122521. PMID: 26582179

Clinical prediction guides

Downregulation of 5-hydroxymethylcytosine is an early event in pancreatic tumorigenesis.
Fujikura K, Alruwaii ZI, Haffner MC, Trujillo MA, Roberts NJ, Hong SM, Macgregor-Das A, Goggins MG, Roy S, Meeker AK, Ding D, Wright M, He J, Hruban RH, Wood LD
J Pathol 2021 Jul;254(3):279-288. Epub 2021 May 21 doi: 10.1002/path.5682. PMID: 33870509Free PMC Article
mAb Das-1 identifies pancreatic ductal adenocarcinoma and high-grade pancreatic intraepithelial neoplasia with high accuracy.
Das KK, Brown JW, Fernandez Del-Castillo C, Huynh T, Mills JC, Matsuda Y, Das KM, Mino-Kenudson M
Hum Pathol 2021 May;111:36-44. Epub 2021 Jan 30 doi: 10.1016/j.humpath.2021.01.003. PMID: 33524436Free PMC Article
High-risk lesions in the remnant pancreas: fate of the remnant pancreas after pancreatic resection for pancreatic cancer and intraductal papillary mucinous neoplasms.
Miyasaka Y, Ohtsuka T, Matsuda R, Mori Y, Nakata K, Ohuchida K, Nakamura M
Surg Today 2020 Aug;50(8):832-840. Epub 2019 Jul 25 doi: 10.1007/s00595-019-01852-3. PMID: 31346809
High-grade pancreatic intraepithelial lesions: prevalence and implications in pancreatic neoplasia.
Park JR, Li F, Oza VM, Sklaw BC, Cronley KM, Wellner M, Swanson B, Krishna SG
Hepatobiliary Pancreat Dis Int 2017 Apr;16(2):202-208. doi: 10.1016/s1499-3872(16)60186-8. PMID: 28381386
New strategies for the early detection of pancreatic cancer.
Petrone MC, Arcidiacono PG
Expert Rev Gastroenterol Hepatol 2016;10(2):157-9. Epub 2015 Dec 14 doi: 10.1586/17474124.2016.1122521. PMID: 26582179

Recent systematic reviews

Diagnostic Yield From Screening Asymptomatic Individuals at High Risk for Pancreatic Cancer: A Meta-analysis of Cohort Studies.
Corral JE, Mareth KF, Riegert-Johnson DL, Das A, Wallace MB
Clin Gastroenterol Hepatol 2019 Jan;17(1):41-53. Epub 2018 Jun 30 doi: 10.1016/j.cgh.2018.04.065. PMID: 29775792

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