Connective tissue growth factor expression in precancerous lesions of human esophageal epithelium and prognostic significance in esophageal squamous cell carcinoma


  • Author's contribution: Li LY contributed to the pathological scoring, study design, date collection, date analysis and interpretation, and drafting for 22% of the study work; Li EM and Xu LY contributed to study design, data analysis and interpretation, and revised the manuscript for 16% and 18%, separately; Wu ZY contributed to patients' date collection for 9%; Huang X contributed to quantitative real-time RT-PCR analysis for 9%; Shen JH contributed to pathological review for 8%; Xu XE contributed to tissue microarray construction and immunochemistry process for 9%; Wu JY and Huang Q contributed to follow-up trace for 5% and 4% in the study work.

Miss Li-Yan Xu, PhD, Institute of Oncologic Pathology, Medical College of Shantou University, No.22, Xinling Road, Shantou, Guangdong 515041, China. Email:


Connective tissue growth factor (CTGF, CCN2), a secreted protein, is involved in the development and progression of esophageal squamous cell carcinoma (ESCC). However, it remains unclear how CTGF expression affects the progression of ESCC. Our study implicated differences of CTGF protein status in precancerous lesions, and retrospectively examined the associations of CTGF mRNA and protein levels with clinical prognosis in ESCC patients. Here immunohistochemistry and the quantitative real-time real-time reverse transcription polymerase were performed for predicting the CTGF protein status and mRNA levels in ESCC patients, respectively. Different degrees of CTGF protein status presented in normal human esophageal epithelium and precancerous lesions, and CTGF protein was highly expressed in ESCCs. Survival analysis showed that CTGF protein status was significantly related to poor survival of ESCC patients (P= 0.024), while no significant difference was observed between CTGF mRNA levels and the survival of ESCC patients (P= 0.196). Multivariate Cox analysis demonstrated that CTGF protein status was the independent factor in prognosis of ESCC patients. In that way, CTGF protein status might elevate the progression of ESCC, and would be significant for the diagnosis of precancerous lesions or early ESCC.