Precursors to invasive pancreatic cancer

Jessica A Smith, Aatur D Singhi, Anirban MaitraDepartment of Pathology, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine, Baltimore, MD, USAAbstract: Pancreatic ductal adenocarcinoma (PDAC) is a lethal disease, with a 5-year survival rate of less than 5%. To better understand PDAC and to improve its dismal prognosis, we must understand its origins. PDAC has three distinct noninvasive precursor lesions including intraductal papillary mucinous neoplasm, mucinous cystic neoplasm, and pancreatic intraepithelial neoplasia. Each of these precursor lesions has its own unique compendium of clinical findings, morphological features, and genetic aberrations. This review focuses on the clinical significance of precursor lesions of pancreatic cancer and how better understanding of these lesions can aid in early detection and treatment.Keywords: pancreatic ductal adenocarcinoma, precursor lesions, intraductal papillary mucinous neoplasm, mucinous cystic neoplasm, pancreatic intraepithelial neoplasia, PanIN