Expression of ALDH1 in axillary lymph node metastases is a prognostic factor of poor clinical outcome in breast cancer patients with 1–3 lymph node metastases

Nogami, Tomohiro; Shien, Tadahiko; Tanaka, Takehiro; Nishiyama, Koichiro; Mizoo, Taeko; Iwamto, Takayuki; Ikeda, Hirokuni; Taira, Naruto; Doihara, Hiroyoshi; Miyoshi, Shinichiro

doi:10.1007/s12282-012-0350-5

Cited by 25 publications

(30 citation statements)

References 25 publications

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“…Only few previous studies have thus far compara- tively studied CSCs in primary tumors with their associated metastases. It was reported that increased ALDH1 expression in patients with breast cancer lymph node metastases serves as a prognostic factor of poor clinical outcome (26).…”

Section: Discussionmentioning

confidence: 99%

ALDH1-positive cancer stem-like cells are enriched in nodal metastases of oropharyngeal squamous cell carcinoma independent of HPV status

Qian

Wagner

et al. 2013

Oncology Reports

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Abstract. Oropharyngeal squamous cell carcinoma (OSCC) is caused by high-risk (HR) human papillomavirus (HPV) or alcohol and tobacco abuse. Aldehyde dehydrogenase 1 (ALDH1) is a confirmed marker for cancer stem-like cells (CSCs) of OSCC responsible for therapy resistance, recurrence and metastasis. Associations between HR-HPV/p16, CSC frequency and clinicopathological parameters in patients with metastatic OSCC were investigated. In the present study, HPV genotypes and expression of ALDH1 and p16 was analyzed in 40 paired OSCC and metastases. A significant correlation between ALDH1 positivity with lower primary tumor differentiation grade (P=0.009) and higher nodal status (P=0.015) was noted. Compared to primary tumors, the proportion of ALDH1-expressing cells was significantly increased in metastases (P=0.012), while significantly fewer ALDH1-expressing cells were found in HR-HPV-DNA + /p16 + primary tumors (P=0.038) compared to HR-HPV-DNA -/p16 -primary tumors. Metastases showed no difference. ALDH1 + CSCs are detectable in OSCC and metastases. ALDH1 high-grade OSCC exhibits a more aggressive phenotype characterized by higher nodal classification and lower differentiation. This suggests a subpopulation contained in the ALDH1-positive OSCC cell pool able to complete the metastatic cascade and subsequently enriching in metastasis independent of tumor etiology and ALDH1 content.

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Section: Discussionmentioning

confidence: 99%

ALDH1-positive cancer stem-like cells are enriched in nodal metastases of oropharyngeal squamous cell carcinoma independent of HPV status

Qian

Wagner

et al. 2013

Oncology Reports

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“…For references that did not provide HRs, we referred to the methods described by Tierney et al . [20] to obtain the HRs using the data and figures from the original papers [19,21-23]. …”

Section: Methodsmentioning

confidence: 99%

ALDH1A1 expression correlates with clinicopathologic features and poor prognosis of breast cancer patients: a systematic review and meta-analysis

Liu

Duan

et al. 2014

BMC Cancer

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BackgroundAldehyde dehydrogenase 1 family member A1 (ALDH1A1) has been identified as a putative cancer stem cell (CSC) marker in breast cancer. However, the clinicopathological and prognostic significance of this protein in breast cancer patients remains controversial.MethodsThis meta-analysis was conducted to address the above issues using 15 publications covering 921 ALDH1A1+ cases and 2353 controls. The overall and subcategory analyses were performed to detect the association between ALDH1A1 expression and clinicopathological/prognostic parameters in breast cancer patients.ResultsThe overall analysis showed that higher expression of ALDH1A1 is associated with larger tumor size, higher histological grade, greater possibility of lymph node metastasis (LNM), higher level expression of epidermal growth factor receptor 2 (HER2), and lower level expression of estrogen receptor (ER)/progesterone receptor (PR). The prognosis of breast cancer patients with ALDH1A1+ tumors was poorer than that of the ALDH1A1- patients. Although the relationships between ALDH1A1 expression and some clinicopathological parameters (tumor size, LNM, and the expression of HER2) was not definitive to some degree when we performed a subcategory analysis, the predictive values of ALDH1A1 expression for histological grade and survival of breast cancer patients were significant regardless of the different cutoff values of ALDH1A1 expression, the different districts where the patients were located, the different clinical stages of the patients, the difference in antibodies used in the studies, and the surgery status.ConclusionsOur results indicate that ALDH1A1 is a biomarker to predict tumor progression and poor survival of breast cancer patients. This marker should be taken into consideration in the development of new diagnostic and therapeutic program for breast cancer.

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“…The hazard ratio for patients with one to three node involvement compared with none was 1.2 (95% CI=0.8-1.9) and it was 2.5 (95% CI=1.8-3.4) among four or more involved nodes, respectively. Other studies reported the significant higher HR of DFS among patients with than those without axillary lymph node metastasis (ALNM) (Rosa Mendoza et al, 2013;Nogami et al, 2014 ).…”

Section: Discussionmentioning

confidence: 99%

“…Prognostic and predictive factors for breast cancer include classical clincopathological features derived from breast cancer samples including stage, tumor size, histological subtype and grade, lymph node metastases (Rosa Mendoza ES et al, 2013;Nogami T et al, 2014 ), type of tumor, lymphatic and vascular invasion (Jatoi et al, 1999 ), and hormone receptor status (Weigel, 2010).…”

mentioning

confidence: 99%

Side Population Cell Level in Human Breast Cancer and Factors Related to Disease-free Survival

Jin¹,

Zou²,

Li³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Expression of ALDH1 in axillary lymph node metastases is a prognostic factor of poor clinical outcome in breast cancer patients with 1–3 lymph node metastases

Abstract: Evaluation of biomarker expression in ALNM could be useful for prognosis in breast cancer patients with 1-3 metastatic lymph nodes.

Cited by 25 publications

References 25 publications

ALDH1-positive cancer stem-like cells are enriched in nodal metastases of oropharyngeal squamous cell carcinoma independent of HPV status

ALDH1-positive cancer stem-like cells are enriched in nodal metastases of oropharyngeal squamous cell carcinoma independent of HPV status

ALDH1A1 expression correlates with clinicopathologic features and poor prognosis of breast cancer patients: a systematic review and meta-analysis

Side Population Cell Level in Human Breast Cancer and Factors Related to Disease-free Survival

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