Developmental aspects of early pancreatic cancer

The specific cell of origin responsible for generating pancreatic intraepit helial neoplasia and pancreatic ductal adenocarcinoma remains unknown. Duri ng development, epithelial stem cells within embryonic pancreatic epitheliu m give rise to mature acinar, ductal, and islet elements. Emerging evidence suggests that cells with precursor potential also exist within adult pancr eas, resulting in significant developmental plasticity among both endocrine and exocrine cell types. In this review, the contribution of developmental plasticity in initiating pancreatic metaplasia and neoplasia is considered , and evidence supporting a role for epithelial stem cells in pancreatic ca ncer is discussed.