The Relationship Between The Expression Of CTGF And SDF-1 And Formation Of Anastomosis Scar

Abstract:objective:To observe the expression characteristics of CTGF, SDF-1 and their receptors on esophagus anastomotic stoma mucosa shortly after surgery, at a operation 12 weeks after esophagectomy in patients with esophageal carcinoma, and to explore the roles and predictive value of them in the pathogenesis of anastomotic stricture. Methods:40 patients were recruited in the study with esophageal cancer diagnosed, who had been underwent esophagectomy, and no anastomotic tumor recurrence occured by pathology in 12 week after operation. Swallowing barium contrast examination were executed in all patients. According to the diameter of anastomotic stoma, the patients were divided into two groups:Non-anastomotic stenosis group (N) and anastomotic stenosis group (A). And they were underwent by video endoscopy, and pathology tissue at anastomotic stoma was clamped. At the same time, the surgical margin specimens were obtained. CTGF and SDF-1 expression were analyzed and measured by immunohistochemistry in all specimens. Results:1. The expression of connective tissue growth factor (CTGF) was mainly localized in the cytoplasm. CTGF were expressed within the cytoplasm of esophageal epithelial cells, endothelial cells and fibroblasts. Stromal cell-derived factor-1 (SDF-1) was localized mainly in the cytoplasm, which is stained slightly, and some were granular.2. At cut edges of esophagus, CTGF expression in group A was 42.8%±3.1%. And it was significantly higher than that in group N (27.2%±3.5%) (P<0.01). At scar tissue of stoma, CTGF was 52.7%±6.2%, which was significantly higher than that in group N (29.7%±5.9%) (P<0.01).3. At cut edges of esophagus, SDF-1 expression both in the two groups were at a lower level, and it was 0.56%±0.67%, or 0.64%±0.65%, respectively, (P> 0.05). SDF-1 expression in group A was 20.8%±4.2%, significantly higher than that in group N at the time of 12 weeks after surgery (13.3%±2.7%) (P<0.01). Conclusion:(1) CTGF expression of esophageal anastomotic stoma at the time of surgery, postoperative 12 weeks in anastomotic stenosis group, was significantly higher than that in Non-anastomotic stenosis group. Consequencely, increased CTGF levels on esophagus cut edges could plays an important role in prediction anastomotic stricture at postoperative. (2) SDF-1 express was at very low level in normal esophageal tissues, and it was no significance in prediction anastomotic stricture after esophagectomy in esophageal cancer patients. (3) Over-expression of CTGF and SDF-1 in scar tissue is closely related to excessive scar formation and they could contributed to anastomotic stenosis after operation in esophageal cancer patients.