Furthermore, a considerable increase in LDHA and MCT4 staining was also observed in patients with IPMN lesions, mainly in those diagnosed with high-grade IPMN who later (after surgical resection of IPMN lesion) progressed to adenocarcinoma or whose resected pancreas specimens already contained IPMN-associated adenocarcinoma, compared to patients with only benign IPMN [142]. Here, LDHA is linked to adenocarcinoma.