Fujiwara S, et al. - Researchers examined the link between pancreatic intraepithelial neoplasia (PanIN), one of the major precursor lesions of pancreatic ductal adenocarcinoma (PDAC), and epithelial-to-mesenchymal transition (EMT). Immunohistochemically, they searched for possible regulators of EMT. They analyzed expressions of SNAIL, SLUG, TWIST1, and ZEB1 in high-grade PanIN (HG-PanIN) and PDAC. Overall, 71 PDAC patients with surgically resected specimens were included. A significantly better relapse-free survival (median survival time [MST] of 11.3 months vs 4.4 months) and overall survival (MST of 25.2 months vs 13.6 months) was observed in PDAC accompanied by SNAIL-positive HG-PanIN. Overall, a possible significant role of EMT in the development of PDAC from HG-PanIN was suggested. A distinct subgroup with a better prognosis could be predicted by SNAIL.