Expression of connective tissue growth factor in tumor tissues is an independent predictor of poor prognosis in patients with gastric cancer

AIM: To examine the expression of connective tissue growth factor (CTGF), also known as CCN2, in gastric carcinoma (GC), and the correlation between the expression of CTGF, clinicopathologic features and clinical outcomes of patients with GC. METHODS: One hundred and twenty-two GC patients were included in the present study. All patients were followed up for at least 5 years. Proteins of CTGF were detected using the Powervision two-step immunostaining method. RESULTS: Of the specimens from 122 GC patients analyzed for CTGF expression, 58 (58/122, 47.5%) had a high CTGF expression in cytoplasm of gastric carcinoma cells and 64 (64/122, 52.5%) had a low CTGF expression. Patients with a high CTGF expression showed a higher incidence of lymph node metastasis than those with a low CTGF expression (P = 0.032). Patients with a high CTGF expression had significantly lower 5-year survival rate than those with a low CTGF expression (27.6% vs 46.9%, P = 0.0178), especially those staging Ⅰ+Ⅱ+Ⅲ (35.7% vs 65.2%, P = 0.0027). CONCLUSION: GC patients with an elevated CTGF expression have more lymph node metastases and a shorter survival time. CTGF seems to be an independent prognostic factor for the successful differentiation of high-risk GC patients staging Ⅰ+Ⅱ+Ⅲ. Over-expression of CTGF in human GC cells results in an increased aggressive ability.

Pericryptal Fibroblast Sheath in Intestinal Metaplasia,Dysplasia and Carcinoma of the Stomach

Objective： To investigate the existence of pericryptal fibroblasts sheath （PCFS） in normal gastric mucosa, intestinal metaplasia （IM）, indefinite for dysplasia （I-Dys）, low grade dysplasia （L-Dys）, high grade dysplasia （H-Dys） and gastric cancer （GC）, and its association with gastric carcinogenesis. Methods： In this study, we examined the existence of PCFS in normal gastric mucosa （N=10）, IM （N=26）, I-Dys （N=16）, L-Dys （N=13）, H-Dys （N=21） and GC （N=145） using immunohistochemical staining for two smooth muscle markers, alpha smooth muscle actin（α-SMA） and high molecular weight caldesmon （h-CD）. The significance of PCFS was discussed, especially in association with gastric carcinogenesis. Results： The PCFS was recognized in 65.4%（17/26） of IM, 62.5%（10/16） of I-Dys and 23.1% （3/13） of L-Dys respectively. No PCFS was detected in H-Dys and GC. The PCFS was gradually reduced in IM, Dys and GC in sequence （P〈0.0001）. Conclusion： The PCFS is associated with the differentiation of epithelium and involved in gastric carcinogenesis via epithelial-mesenchymal interaction.