ArticleBMC medicine2026
γH2AX and p53 Immunohistochemistry predict the incidence risk of esophageal squamous precancerous lesions.
Article in BMC medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCurrent screening practices for esophageal squamous cell carcinoma (ESCC) subject to both over- and under-surveillance of precancerous lesions. This study aims to evaluate potential immunohistochemical (IHC) markers associated with the incidence of ESCC and to establish an IHC-based panel for surveillance.
methodsTissue microarrays were constructed using 946 formalin-fixed, paraffin-embedded (FFPE) samples from 883 participants with baseline Lugol-unstained lesions (LULs) enrolled in a population-based screening trial. Candidate IHC markers were identified from literature and our previous findings. IHC results (H-scores) were quantified via HALO software, and optimal cut-offs were set by X-tile. Incident esophageal malignancy identified during a median follow-up of 11.76 years served as the outcome. Cox regression models were applied to identify predictive markers.
resultsEight candidate markers were evaluated. After multivariable adjustment and backward elimination, γH2AX and p53 were identified as significant predictors [HR (95% CI)
conclusionsγH2AX, a novel incidence-warning IHC marker for esophageal squamous precancerous lesions, combined with p53, showed robust and durable predictive performance for incident malignancy after one-time screening. Integrating IHC testing could help refine risk stratification and mitigate over- and under-surveillance within current ESCC screening protocol.
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