PMID- 28381386
OWN - NLM
STAT- MEDLINE
DCOM- 20171023
LR  - 20220316
IS  - 1499-3872 (Print)
VI  - 16
IP  - 2
DP  - 2017 Apr
TI  - High-grade pancreatic intraepithelial lesions: prevalence and implications in 
      pancreatic neoplasia.
PG  - 202-208
AB  - BACKGROUND: High-grade pancreatic intraepithelial neoplasia (PanIN-3), a 
      precursor of pancreatic ductal adenocarcinoma (PDAC), is not universally detected 
      in resected pancreatic neoplasms. We sought to determine the prevalence and 
      prognostic relevance of PanIN-3 lesions in primary surgical resections of PDACs 
      and intraductal papillary mucinous neoplasms (IPMNs). METHODS: A retrospective 
      review of a tertiary care center pathology database (1/2000-6/2014) was 
      performed. Demographics, imaging, pathology, disease-recurrence, and survival 
      data were reviewed. RESULTS: A total of 458 patients who underwent primary 
      pancreatic resection were included. "PanIN-3" lesions were found in 74 (16.2%) 
      patients who either had PDAC (n=67) or main duct (MD)-IPMN (n=7). Among IPMN-MDs, 
      PanIN-3 lesions were exclusively found in those with pathological evidence of 
      chronic pancreatitis. For PDACs, the median overall survival (OS) for pancreata 
      with PanIN-3 lesions was significantly better than those without (OS 1.12 years, 
      inter-quartile range [IQR] 0.72, 2.05 years vs OS 0.86 years, IQR 0.64, 1.60 
      years respectively; P=0.04). Multivariate Cox regression analysis demonstrated 
      that the presence of PanIN-3 lesions was associated with a reduced risk of death 
      (HR=0.43; 95% CI: 0.23-0.82; P=0.01). CONCLUSIONS: Following primary resection of 
      pancreatic adenocarcinoma, the lower survival observed in patients without 
      PanIN-3 lesions might suggest a state of complete or accelerated transformation. 
      Further investigations are necessary to validate these findings that might impact 
      disease prognosis and management.
FAU - Park, Jean R
AU  - Park JR
AD  - Division of Hospital Medicine, Division of Gastroenterology, Hepatology and 
      Nutrition, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA. 
      Somashekar_krishna@osumc.edu.
FAU - Li, Feng
AU  - Li F
FAU - Oza, Veeral M
AU  - Oza VM
FAU - Sklaw, Brett C
AU  - Sklaw BC
FAU - Cronley, Kevin M
AU  - Cronley KM
FAU - Wellner, Michael
AU  - Wellner M
FAU - Swanson, Benjamin
AU  - Swanson B
FAU - Krishna, Somashekar G
AU  - Krishna SG
LA  - eng
PT  - Journal Article
PL  - Singapore
TA  - Hepatobiliary Pancreat Dis Int
JT  - Hepatobiliary & pancreatic diseases international : HBPD INT
JID - 101151457
SB  - IM
MH  - Adenocarcinoma, Papillary/mortality/*pathology/surgery
MH  - Aged
MH  - Carcinoma in Situ/mortality/*pathology/surgery
MH  - Carcinoma, Pancreatic Ductal/mortality/*pathology/surgery
MH  - Chi-Square Distribution
MH  - Databases, Factual
MH  - Female
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Neoplasm Grading
MH  - Neoplasm Recurrence, Local
MH  - Neoplasms, Cystic, Mucinous, and Serous/mortality/*pathology/surgery
MH  - Ohio
MH  - Pancreatectomy
MH  - Pancreatic Neoplasms/mortality/*pathology/surgery
MH  - Proportional Hazards Models
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Tertiary Care Centers
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2017/04/07 06:00
MHDA- 2017/10/24 06:00
CRDT- 2017/04/07 06:00
PHST- 2017/04/07 06:00 [entrez]
PHST- 2017/04/07 06:00 [pubmed]
PHST- 2017/10/24 06:00 [medline]
AID - S1499-3872(16)60186-8 [pii]
AID - 10.1016/s1499-3872(16)60186-8 [doi]
PST - ppublish
SO  - Hepatobiliary Pancreat Dis Int. 2017 Apr;16(2):202-208. doi: 
      10.1016/s1499-3872(16)60186-8.