Abstract: ObjectiveTo investigate the relationship between p53 expression and proliferation and apoptosis in esophageal carcinoma development. MethodsEight hundred and eighteen cases (male 414 and female 404) continuously were biopsied in esophagus. Apoptosis index (AI) was examined by TUNEL, and proliferation index (PI) and p53 was identified by immunohistochemistry. ResultsFrom normal epithelium(694 cases),simple hyperplasia(39 cases),mild and moderate dysplasia(24 cases) to esophageal squamous cell carcinoma (ESCC, 61cases), the grades of AI was gradually lowered with the development of pathological situation, whereas the grades of PI and the expression of p53 were gradually increased with statistical significance. In normal epithelium the grade of AI was negative correlated to the grade of PI and p53, furthmore, a positive correlation between grade of PI and p53 was observed. In the simple hyperplasia the grade of AI to p53 was negative correlation, the grade of PI to p53 was positive correlation. In mild and moderate dysplasia and ESCC, there were no correlation among AI, PI and p53 each other. ConclusionWhich the grade of AI low, PI and p53 raise is the feature of tumor growth of esophageal mucous membrane. In each type of histopathology itself the correlation of apoptosis, proliferation and the expression of p53 may be the mechanism which restricts or promotes canceration. These changes can be as the reference markers of malignance tendency of esophageal epithelium.