[Pre-neoplastic sign in human esophagus]

Gamma-glutamyl Transpeptidase (gamma-GT) activity of abrasive balloon cytocollections from esophagus of a population aged above 35 in high risk area was studied. Gamma-GT positive rate of the 931 subjects studied was increasingly elevated with the severity of histopathologic changes as follows: normal group 10.3% (43/419), hyperplasia group 21.9% (46/210), dysplasia group 43.9% (125/285), pre-carcinoma group 100% (4/4), squamous carcinoma group 77% (10/13). All or most of the gamma-GT positive cells of each group were normal esophageal squamous epithelium (NESE). They may be initial transformed cells similar to discrete gamma-GT rich cell population without morphological changes observed during very early stages of chemical carcinogenesis. In addition, gamma-GT positive hyperplastic cells and dysplasia grade I cells were also observed in some cases, but dysplasia grade II cells with gamma-GT activity were only shown in a few cases. 1-1.5 years after the mass screening, all the gamma-GT positive cases and gamma-GT negative dysplasia cases were planned to be followed. However, only 277 cases were followed and observed. Histopathologic changes developed rapidly in fifteen cases and fourteen of them were gamma-GT positive cases 1-1.5 years before. Thus, the development of gamma-GT activity may show the trend of histopathologic progression. Gamma-GT on NESE, hyperplastic cells and dysplasia grade I cells showed two fates--progression or fade, whereas the fade rate was reversed with the severity of histopathologic changes. Thus, these changes may be the sign of doubtful population to different extents.(ABSTRACT TRUNCATED AT 250 WORDS)