Comparative Study of Pathological and Imaging Findings in High-Grade Pancreatic Intraepithelial Neoplasia: A Multicenter Analysis by the Japan Study Group on Early Detection of Pancreatic Cancer (JEDPAC).

Authors

Keiji Hanada, Akinori Shimizu, Shujiro Yazumi, Akira Kurita, Toshifumi Kin, Yukiko Takayama, Koji Yoshida, Masayuki Kitano, Reiko Ashida, Mamoru Takenaka, Masahiro Serikawa, Tamito Sasaki, Yasutaka Ishii, Noboru Ideno, Satoru Yasukawa, Akio Yanagisawa, Toru Furukawa, Atsushi Kanno, Takao Ohtsuka, Hiroyuki Maguchi, Masao Tanaka

Published in

Pancreas. Aug 20, 2026. Epub Aug 20, 2026.

Abstract

High-grade pancreatic intraepithelial neoplasia (HG-PanIN) is a non-invasive precursor of pancreatic ductal adenocarcinoma (PDAC) that is notoriously difficult to detect preoperatively because it lacks a discrete mass. Comprehensive imaging-pathology correlation studies focusing exclusively on HG-PanIN remain limited.
We retrospectively analyzed 50 patients with surgically resected, pathologically confirmed HG-PanIN without invasive carcinoma from 11 institutions participating in the Japan Study Group on Early Detection of Pancreatic Cancer (JEDPAC). Central pathological review classified lesions by ductal involvement pattern: Group A (main pancreatic duct [MPD] only), Group B (MPD plus branch ducts), and Group C (branch ducts only). Imaging findings on CT, MRI/MRCP, and endoscopic ultrasound (EUS) were correlated with pathological intraductal spread length. Diagnostic sensitivity of serial pancreatic-juice aspiration cytologic examination (SPACE) and EUS-guided fine-needle aspiration (EUS-FNA) was compared.
The median follow-up was 63 months. Five-year overall survival was 92%, with remnant pancreas recurrence observed in 12%. MPD stenosis was consistently observed in MPD-involved lesions, even with minimal intraductal spread. Periductal hypoechoic areas and focal pancreatic atrophy increased with greater intraductal extension. Group C lesions frequently presented as cystic changes without MPD stenosis. SPACE showed a higher diagnostic yield than EUS-FNA in this cohort (77.1% vs. 25.0%), although this comparison was limited by the small number of EUS-FNA cases.
HG-PanIN exhibits distinct imaging patterns that correlate closely with ductal involvement and pathological extent. Localized MPD stenosis is the earliest imaging hallmark, and SPACE may be a useful diagnostic tool for non-mass-forming lesions. Integration of imaging, cytology, and pathology is essential for early detection of pancreatic cancer.

PMID:
42641132
Bibliographic data and abstract were imported from PubMed on 26 Aug 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.