title: Expression of connective tissue growth factor is a prognostic marker for patients with intrahepatic cholangiocarcinoma.
abstract: OBJECTIVE
  Connective tissue growth factor is a member of the 'CCN' protein family. Consistent with its profibrotic properties, it is over-expressed in several human epithelial malignancies.
  
  
  METHODS
  We have retrospectively evaluated by immunohistochemistry the presence of connective tissue growth factor in archival tissues from 55 resected intrahepatic cholangiocarcinomas and compared its expression to the main pathological parameters, disease free and overall survival.
  
  
  RESULTS
  Tumours were scored as high and low/absent expressers (> or =50%, 0-50% cells, respectively). Thirty-three of 55 cholangiocarcinomas (60%) were high and 22 (40%) low expressers. No significant correlation was found between connective tissue growth factor and tumour grade, tumour location, vascular and perineural invasion. Eighteen of 22 (82%) low/absent expressers and 12/33 (36%) high expressers had recurrence of disease (P=0.001). Low/absent expressers showed a poor disease free and overall survival compared with the higher expressers (P<0.001). Vascular invasion was related to tumour recurrence (P=0.025) and to decreased disease free survival (P<0.05). During proportional hazard regression analysis, only connective tissue growth factor was found to influence disease free survival (P=0.01).
  
  
  CONCLUSIONS
  Expression of connective tissue growth factor is an independent prognostic indicator of both tumour recurrence and overall survival for intrahepatic cholangiocarcinoma patients regardless of tumour location, tumour grade, vascular and perineural invasion.
authors.affiliation: Department of Surgery and Transplantation, Surgical Unit, Policlinico S. Orsola-Malpighi, University of Bologna, Bologna, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Gardini
authors.forename: B
authors.initials: B
authors.lastname: Corti
authors.forename: M
authors.initials: M
authors.lastname: Fiorentino
authors.forename: A
authors.initials: A
authors.lastname: Altimari
authors.forename: G
authors.initials: G
authors.lastname: Ercolani
authors.forename: G L
authors.initials: GL
authors.lastname: Grazi
authors.forename: A D
authors.initials: AD
authors.lastname: Pinna
authors.forename: W F
authors.initials: WF
authors.lastname: Grigioni
authors.forename: A
authors.initials: A
authors.lastname: D'Errico Grigioni
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000378:metabolism / Q000473:pathology*; D001653:Bile Ducts, Intrahepatic / Q000378:metabolism / Q000473:pathology*; D014408:Biomarkers, Tumor / Q000032:analysis; D018281:Cholangiocarcinoma / Q000378:metabolism / Q000473:pathology*; D055513:Connective Tissue Growth Factor; D005260:Female; D006801:Humans; D017874:Immediate-Early Proteins / Q000096:biosynthesis*; D007150:Immunohistochemistry; D036341:Intercellular Signaling Peptides and Proteins / Q000096:biosynthesis*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D014408:Biomarkers, Tumor; C526317:CCN2 protein, human; D017874:Immediate-Early Proteins; D036341:Intercellular Signaling Peptides and Proteins; D055513:Connective Tissue Growth Factor