Fig. 1: EMT and the progression of PDAC.

A The EMT process during PDAC progression. NPC undergo ADM, progressing to low-grade PanIN (I A/B), and high-grade PanIN (II/III) finally progressing to PDAC. PDAC progression inherently results in the acquisition of EMT-associated features. B The inherent circulatory properties of PDAC enable it to undergo EMT at any stage in its progression. EMT is a prerequisite for PDAC invasion and diffusion, and following extravasation and colonization of a distant site, the cells undergo MET to complete the metastatic journey. C The migration of PDAC cells can occur via one of two EMT programs, individual and populations of cells undergo p-EMT, which results in a high invasive capacity, whilst c-EMT is achieved in an individual-cell pattern, and has a low invasive potential. ADM acinar–ductal metaplasia, c-EMT complete EMT, EMT epithelial-mesenchymal transition, MET mesenchyme-epithelial transformation, NPC normal pancreatic cell, PanIN pancreatic intraepithelial neoplasia, PDAC pancreatic ductal adenocarcinomas, p-EMT partial EMT.