title: The roles of connective tissue growth factor in the development of anastomotic esophageal strictures.
abstract: BACKGROUND
  The aim of this study was to investigate the roles of connective tissue growth factor (CTGF) in the development of anastomotic strictures after surgical repair of the esophagus.
  
  
  METHODS
  Tissues collected from the patients were divided into three groups based on the results of endoscopy and clinical grading. Patients without dysphagia after esophagectomy were used as the control population. The protein levels of CTGF, TGF-β1, Smad2, and Smad4 were determined by immunohistochemistry (IHC) and western blot analyses, while the mRNA levels of the two growth factors were evaluated by real-time polymerase chain reaction.
  
  
  RESULTS
  Compared with the control group, significantly increased (p < 0.01) levels of CTGF and TGF-β1 protein were observed in the anastomotic stenosis (AS) group, and levels of the two proteins detected by the IHC and western blot analyses were also significantly increased with the increasing severity of stenosis (p < 0.05). The mRNA levels of CTGF and TGF-β1 in the tissues collected from the patients with stenosis were significantly up-regulated (p < 0.05) as compared with those from the control group. In addition, the levels of Smad2 and Smad4 protein were also significantly increased (p < 0.05) with the increasing severity of stenosis, and the protein levels were positively correlated with the levels of CTGF (r = 0.59, p < 0.05) and TGF-β1 (r = 0.63, p < 0.05).
  
  
  CONCLUSIONS
  Inhibition of CTGF protein or mRNA expression may be a distinctive and effective therapy for the treatment of postoperative anastomotic strictures.
authors: Department of Pathology, the 101 Hospital of Chinese People's Liberation Army, Wuxi, Jiangsu Province, China.
authors: Haibin
authors: H
authors: Zhao
authors: Department of Pathology, the 101 Hospital of Chinese People's Liberation Army, Wuxi, Jiangsu Province, China.
authors: Lingna
authors: L
authors: Zhao
authors: Department of Pathology, the 101 Hospital of Chinese People's Liberation Army, Wuxi, Jiangsu Province, China.
authors: Zhihua
authors: Z
authors: Zhou
authors: Department of Pathology, the 101 Hospital of Chinese People's Liberation Army, Wuxi, Jiangsu Province, China.
authors: Yaoyi
authors: Y
authors: Wu
keywords: anastomotic strictures; connective tissue growth factor; esophageal cancer; surgical repair of the esophagus; transforming biochemical factors