Department of Molecular and Cellular Pathology, Field of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Histopathology. 2011 Mar;58(4):608-16. doi: 10.1111/j.1365-2559.2011.03781.x. Epub 2011 Mar 3.
Aldehyde dehydrogenase 1 (ALDH1) has been identified as a reliable marker of breast cancer stem cells. The aim was to determine the prognostic significance of ALDH1 expression in a long-term follow-up study.
Immunohistochemical analyses were performed on 257 invasive ductal carcinomas (IDCs), 109 matched lymph node metastases and 190 ductal carcinomas in situ (DCISs), using paraffin-embedded sections. ALDH1 expression was found in 26% of IDCs, and correlated with larger tumour size (P=0.007), high histological grade (P<0.001), HER2 overexpression (P<0.001) and negative hormone receptor status (P<0.001). ALDH1 expression was observed in 14% of DCISs but was not correlated with any clinicopathological parameter. The IDC patients were followed up for 7-190 months (median: 120 months), and groups with ALDH1 expression had shorter relapse-free survival (P=0.0013) and overall survival (OS) (P=0.0005) by log-rank test. By Cox's multivariate analysis, it had a weak effect on OS (P=0.047), and its most significant effect on OS was observed in node-positive groups (P=0.013). No significant differences in OS stratified by ALDH1 expression status in lymph node metastases were noted.
ALDH1 expression in primary cancer is an independent prognostic factor in node-positive breast cancer patients.
醛脱氢酶 1（ALDH1）已被确定为乳腺癌干细胞的可靠标志物。本研究旨在通过长期随访研究确定 ALDH1 表达的预后意义。
使用石蜡包埋切片对 257 例浸润性导管癌（IDC）、109 例匹配的淋巴结转移和 190 例导管原位癌（DCIS）进行免疫组织化学分析。在 IDC 中发现 26%的病例表达 ALDH1，且与肿瘤较大（P=0.007）、组织学分级高（P<0.001）、HER2 过表达（P<0.001）和激素受体阴性（P<0.001）相关。在 DCIS 中观察到 14%的病例表达 ALDH1，但与任何临床病理参数均无关。IDC 患者随访 7-190 个月（中位数：120 个月），ALDH1 表达组无复发生存率（P=0.0013）和总生存率（OS）（P=0.0005）均通过对数秩检验缩短。通过 Cox 多因素分析，其对 OS 有微弱影响（P=0.047），在淋巴结阳性组中其对 OS 的影响最显著（P=0.013）。在淋巴结转移中，根据 ALDH1 表达状态分层的 OS 无显著差异。
原发性癌症中 ALDH1 的表达是淋巴结阳性乳腺癌患者的独立预后因素。
