WHAT IS THE EARLIEST MALIGNANT LESION IN THE ESOPHAGUS

BACKGROUND. The incidence of early esophageal cancer is definitely inc reasing due to recent advances in diagnostics. When we discuss early c arcinoma of the esophagus, however, there is still controversy as to w hether dysplasia is either benign or the earliest malignant lesion. ME THODS. Nineteen resected esophaguses with both cancer and dysplasia (i ncluding 19 cancers concomitant with 26 dysplastic lesions) were studi ed for expression of p53 protein. RESULTS. Immunohistochemical overexp ression of p53 protein in esophageal dysplasia is almost the same as t hat in cancer. CONCLUSIONS. Esophageal dysplasia should be recognized as the earliest malignant lesion which already demonstrates cancerous features although it is not immediately critical. A routine endoscopic Lugol's solution test is very useful for both detection and following -up of the early nests in the esophagus. These lesions are good candid ates for endoscopic mucosal resection for the purpose of accurate diag nosis or curative treatment. (C) 1996 American Cancer Society.