From pancreatic intraepithelial neoplasia to cancer: a dramatic progression with K-ras status analysis

Pancreatic ductal carcinomas are thought to arise from precursor ductal lesions called pancreatic intra-epithelial neoplasias or PanlNs. We report the case of a woman suffering from idiopathic chronic pancreatitis associated with PanlNs lesions who developed six years later an invasive ductal carcinoma. Immunokistochemistry for 53, HER-2/neu and genetic analysis of K-ras oncogene were performed at different stages of disease and revealed that the PanlNs and the carcinoma did not express p53 and HER-2/neu gene products whereas a K-ras mutation was present at the carcinoma stage. The relationship between cancer and chronic pancreatitis and the main difficulties concerning the early diagnostic of pancreatic cancer are discussed.