# Presence of somatic mutations in most early-stage pancreatic intraepithelial neoplasia

Source: https://onco.cc/key-papers/paper-kanda-panin-1-somatic-mutations-gastroenterology-2012/  
OnCo record `paper-kanda-panin-1-somatic-mutations-gastroenterology-2012` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

More than 99% of the smallest, lowest-grade precursor lesions in the pancreas already carry a mutation in KRAS, CDKN2A, GNAS or BRAF, showing the genetic change comes first.

## Summary

More than 99% of the earliest-stage, lowest-grade pancreatic intraepithelial neoplasm-1 lesions were shown to contain mutations in KRAS, p16/CDKN2A, GNAS or BRAF.

## Fields

- Kind: Key paper
- Last checked: 2026-09-24
- Journal: Gastroenterology
- Year: 2012
- DOI: 10.1053/j.gastro.2011.12.042
- Authors: Kanda M, Matthaei H, Wu J, et al.
- Findings: More than 99% of PanIN-1 lesions carry a KRAS, CDKN2A, GNAS or BRAF mutation.
- What it means: It fixes the order of events, with the initiating mutation present in the smallest visible lesion, and it warns that finding mutant KRAS in a duct does not mean cancer.
- Caveats: Microdissected lesions; small numbers per grade.; Mutation presence does not predict which lesions progress.

## Sources

- Kanda et al., Gastroenterology 2012: somatic mutations in more than 99% of PanIN-1 lesions: https://doi.org/10.1053/j.gastro.2011.12.042
- PubMed: https://pubmed.ncbi.nlm.nih.gov/22226782/

## Connected records

- cancers: [Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors](https://onco.cc/cancers/ipmn-cystic-precursors/), [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/)
- targets: [BRAF](https://onco.cc/targets/braf/), [CDKN2A](https://onco.cc/targets/cdkn2a/), [GNAS](https://onco.cc/targets/gnas/), [KRAS](https://onco.cc/targets/kras/)
- institutions: [Johns Hopkins Hospital / Sidney Kimmel Comprehensive Cancer Center](https://onco.cc/institutions/johns-hopkins/)
- people: [Anirban Maitra](https://onco.cc/people/anirban-maitra/), [Bert Vogelstein](https://onco.cc/people/bert-vogelstein/)
- journals: [Gastroenterology](https://onco.cc/journals/gastroenterology/)

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