{"entity":{"id":"paper-hruban-panin-nomenclature-ajsp-2001","kind":"paper","name":"Pancreatic intraepithelial neoplasia: a new nomenclature and classification system for pancreatic duct lesions","aka":[],"tldr":"Eight expert pathologists given the same 35 slides used more than 70 different names for the lesions, so they agreed on one system, PanIN grades 1 to 3, which is still the language of pancreatic precursor pathology.","summary":"Thirty-five microscopic slides with representative duct lesions were sent to eight expert pathologists from the United States, Canada and Europe. Interobserver kappa values could not be calculated initially because more than 70 different diagnostic terms were used, with single lesions called hyperplasia, metaplasia, dysplasia or carcinoma in situ. A working group adopted the term pancreatic intraepithelial neoplasia (PanIN) with diagnostic criteria for each grade; on re-review only seven diagnoses were used, with kappa 0.43, 0.14 and 0.42 for PanIN 1, 2 and 3.","asOf":"2026-09-24","links":[{"label":"Hruban et al., Am J Surg Pathol 2001: the PanIN nomenclature","url":"https://doi.org/10.1097/00000478-200105000-00003"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/11342768/"}],"tags":[],"related":[],"cancers":["pancreatic","ipmn-cystic-precursors"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":["johns-hopkins"],"pathways":[],"terms":["biopsy"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"journal":"American Journal of Surgical Pathology","year":2001,"doi":"10.1097/00000478-200105000-00003","pmid":"11342768","authors":"Hruban RH, Adsay NV, Albores-Saavedra J, et al.","paperType":"guideline","findings":["More than 70 terms were in use for the same duct lesions before the system.","PanIN 1 to 3 defined; agreement kappa 0.43, 0.14 and 0.42."],"whatItMeans":"It created the vocabulary that made precursor research possible, and its poor agreement on the middle grade is why the grading later collapsed to two tiers.","caveats":["Agreement on PanIN-2 was poor (kappa 0.14).","Superseded in grading by the 2015 Baltimore consensus."],"changedPractice":true},"route":"/key-papers/paper-hruban-panin-nomenclature-ajsp-2001/","neighbours":{"cancer":[{"id":"ipmn-cystic-precursors","kind":"cancer","name":"Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors","route":"/cancers/ipmn-cystic-precursors/"},{"id":"pancreatic","kind":"cancer","name":"Pancreatic ductal adenocarcinoma","route":"/cancers/pancreatic/"}],"institution":[{"id":"johns-hopkins","kind":"institution","name":"Johns Hopkins Hospital / Sidney Kimmel Comprehensive Cancer Center","route":"/institutions/johns-hopkins/"}],"term":[{"id":"biopsy","kind":"term","name":"Biopsy","route":"/terms/biopsy/"}]}}