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. 2017 Apr 6;8(4):e86. doi: 10.1038/ctg.2017.3

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Copyright © 2017 The Author(s) the American College of Gastroenterology

Clinical and Translational Gastroenterology is an open-access journal published by Nature Publishing Group. This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License. The images or other third party material in this article are included in the article's Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/

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Precursors of pancreatic cancer. Pancreatic ductal adenocarcinoma (PDA) can arise from the progression of IPMN (top) or PanIN (bottom). It is not known whether early IPMNs (incipient IPMN) originate from low-grade PanIN, or develop independently from normal pancreatic ducts or other pancreatic cell lineages. Red and blue circles indicate oncogenes and tumor-suppressor genes, respectively. The precise timing of RNF43 mutations and the order of GNAS and KRAS mutations have not been fully established. IPMN, intraductal papillary mucinous neoplasm; PanIN, pancreatic intraepithelial neoplasia.