Abstract
Esophageal epithelial lesions are important features with respect to the early diagnosis of esophageal cancer. Such lesions include inflammatory reactive lesions (inflammatory reactions, IR) and neoplastic lesions. However, while neoplastic lesions are also classified from low-grade intraepithelial neoplasia (LN) to high-grade intraepithelial neoplasia (HN), it is often difficult to differentiate esophageal epithelial lesions in a biopsy. Therefore, this study analyzed cases of endoscopic mucosal resection (EMR) and dissection by immunostaining for p53, MIB-1, glucose transporter-1 (GLUT-1), and cytokeratin (CK) in addition to cytohistological grading to establish lesions trends for classification. This study included 50 lesions of EMR performed at our hospital from 2004 to 2007, as well as 31 cases who underwent a pathological autopsy at our hospital during the period between 2006 and 2007. Tissue diagnoses by HE staining classified the specimens into five groups: normal, IR, LN, HN, and squamous cell cancer (SCC). This study undertook further comparison by immunostaining for p53, Ki-67 staining, GLUT-1 and CKs 17 and 14. All immunostaining revealed a significant difference between IR and LN grade of lesions. Specifically, GLUT-1 staining revealed a significant difference between LN and HN lesions, while CK17 staining differentiated significantly between HN and SCC. The findings indicated that pathological diagnoses of esophageal lesions should include GLUT-1, CK17, and CK14 immunostaining to differentiate LN and HN lesions.
