Effect Of ALDH1Expression In Cytoplasm Of The Cancer Cells Or In Stroma On The Prognosis Of The Breast Cancer Patients

The recent researches demonstrate that tumor originated from thecancer stem cells(CSCs) or tumor initiated cells（TIC）, which is calledbreast cancer stem cells in breast cancer. The breast cancer cells haveability of infinite proliferation and multi-direction differentiation bythemselves, they are insensitive to chemotherapy or hormone therapy andthey are able to form the tumor once again, therefore the breast cancercells may be the root of the breast cancer recurrence and metastasis.Aldehyde dehydrogenase1（ALDH1）is the basic substance used forfunction and metabolism of the normal stem cells and cancer stem cellsin the tissues, a large number of clinical experiments indicate that whilebreast cancer cells are in possession of high ALDH1activity, it indicatespoor prognosis and lower survivors, which contribute to recurrence andmetastasis. A series of reports prove that ALDH1can be used as breastcancer stem cells ideal marker. There are some reports showing ALDH1are overexpressed in primary cancer cells, which predict poor outcome ofpatients in breast cancer.It is the common consensus thatEMT(Epithelial-mesenchymal transition EMT) plays the important roleduring cancer stem cells implement their biologic function. It is suspectedthat ALDH1expression in stroma cells might be related to EMT in somehow. However,David Rimm found that ALDH1also expressing inthe stroma of breast cancer cells,and effecting the prognosis of the breastcancer patients.So whether the breast cancer cells or themicro-environment effecting on the prognosis of the patients worth ourdeeper research.This study is used immunohistochemical method todetect ALDH1expression in the pathological specimens of160breastcancer patients who accepted surgery in the NO.1bethune hospital of jilinuniversity to study whether the ALDH1expression in cytoplasm of thecancer cells or ALDH1expression in stroma is related with the prognosisof the breast cancer patients, in order to guide future breast cancertreatment.Purpose:To study the effect of ALDH1expression in cytoplasm of the cancercells or in stroma on the prognosis of the breast cancer patients.Materials and methods:Collect165breast cancer patients who accepted breast surgery in theNO.1bethune hospital of jilin university between2003and2008,throughBreast Surgery department follow-up data base,eliminate incomplete5cases,finally in160patients with.The patients are all females,the ages ofpatients range from31to70years(midian,49years),the follow-up periodrange from9to89months (mean follow-up period,59months).Purifiedanti-aldehyde dehydrogenase1-A1/anti-ALDH1A1and S-P IHC reagent.Histological examination of the slice is performed by twoexperienced pathologists.The statistical software SPSS18.0is used toanalysis the data,the differences between groups data are compared byChi-square test, survival analysis is used Kaplan-Meire analysis methodand the log-rank test analysis.Significance level of P<0.05is consideredto be statistically significant.Results:ALDH1expression in cytoplasm of the cancer cells is56cases(35%)while that in stroma is64cases(40%).The relation between ALDH1expression and clinical parameters such as the patients age, tumor size,menstrual history, stage TNM, regional lymph nodemetastasis,ER,PR,Her-2and Ki-67ect were analyzed and showedALDH1expression in stroma has positive correlation with age(P=0.022) and ER expression(P=0.025),no correlation with the otherparameters(P>0.05). Positive ALDH1expression in cytoplasm of cancercells is related with the prognosis of the breast cancer patients(P<0.05).Positive ALDH1expression in stroma of cancer cells is notrelated with the prognosis of the breast cancer patients (P>0.05).Conclusion:1. ALDH1expression in cytoplasm has correlation with the OS andRFS of the breast cancer patients.2. ALDH1expression in stroma has correlation with the age and ER status, but has no correlation with others.ALDH1expression instroma has no correlation with the OS and RFS of the breastcancer patients.3. ALDH1expression in stroma might impose different effects on thebreast cancer from that in the cytoplasm of cancer cells,it may notbe valuated as a parameter for predicting outcome.