The Expression Of Aldehyde Dehydrogenase1in Invasive Primary Breast Tumors And Axillary Lymph Node Metastases Is Associated With Clinical Prognosis

The enzyme aldehyde dehydrogenase1(ALDH1) has been reported as abiomarker for identifying cancer stem cells. Previous studies have shown thatALDH1expression in primary breast cancers was associated with poor clinicalprognosis. In this study, we aimed to determine whether ALDH1expression inaxillary lymph node metastases (ALNM) of breast cancer patients was alsoassociated with poor prognosis. Expression of ALDH1, ER, PgR, HER2andKi-67were examined in primary tumors and ALNM of161patients withinvasive breast cancer. Survival analysis and multivariate analysis were used todetermine the relationship between ALDH1expression and clinical prognosis.Result:Patients with positive ALDH1expression in primary tumors and in ALNMhad significantly shorter relapse-free survival (RFS) times and overall survival(OS) times compared to those whose tissues were ALDH1negative.ALDH1-positivity in primary tumors was significant both in univariate andmultivariate analyses of RFS (P=0.004) and OS (P=0.001). ALDH1expressionin ALNM was significant in a univariate analysis of RFS (P=0.012) and OS(P=0.008) but not in a multivariate analysis of RFS and OS (P>0.05).Conclusion:1. The expression of ALDH1in primary breast tumors or ALNM may beone potential risk factor for poor, long-term outcomes.2. Although ALDH1expression in ALNM was not significant in the multivariate analysis of RFS and OS,but it also has the great potential capacity in indicating prognosis.3.Weconfirmed the hypothesis of CSCs and suggest that the axillary lymph nodemetastases may be due to the metastases of CSCs.4.ALDH1is a reliablebiomarker of marking Breast cancer stem cells.This work was supported by Norman Bethune Program of Jilin University[2012217]. Part of the experiment was respectively posted on the AmericanAssociation for Cancer Research on2012and2013.The related topic of thepaper was published on “Pathology research and practice”(SCI, ImpactFactor:1.3).