Tumors arise through a series of genetic changes which include activat
ion of protooncogenes and inactivation of tumor suppressor genes. It i
s now possible to identify rare cells containing genetic mutations in
an excess background of normal cells. Theoretically, the identificatio
n of a clonal population of cells sharing an early genetic marker for
malignant transformation would lead to valuable intermediate endpoints
and could diagnose premalignant lesions amenable to chemoprevention.
Ideally, these genetic changes would be specific point mutations that
occur early in the tumor cascade, prior to the development of a clinic
ally significant tumor. To identify these markers, precise histopathol
ogic and genetic tumor models must be described. Early candidate marke
rs include p53 point mutations in squamous cell carcinoma of the aerod
igestive tract. (C) 1993 Wiley-Liss, Inc.