age determines the prognostic role of the cancer stem cell marker aldehyde dehydrogenase-1 in breast cancer年龄决定的预后作用癌症干细胞标记醛脱氢酶- 1在乳腺癌.pdfVIP

Mieog et al. BMC Cancer 2012, 12:42 /1471-2407/12/42 RESEARCH ARTICLE Open Access Age determines the prognostic role of the cancer stem cell marker aldehyde dehydrogenase-1 in breast cancer 1† 1† 1,2 1 1 2 J Sven D Mieog , Esther M de Kruijf , Esther Bastiaannet , Peter JK Kuppen , Anita Sajet , Anton JM de Craen , Vincent THBM Smit3, Cornelis JH van de Velde1 and Gerrit-Jan Liefers1* Abstract Background: The purpose of this study was to compare the expression and the prognostic effect of the breast cancer stem cell marker aldehyde dehydrogenase-1 (ALDH1) in young and elderly breast cancer patients. Methods: The study population (N = 574) consisted of all early breast cancer patients primarily treated with surgery in our center between 1985 and 1994. Median follow-up was 17.9 years (range: 0.1 to 23.5). Tissue microarray slides were immunohistochemically stained for ALDH1 expression and quantified by two independent observers who were blinded to clinical outcome. Assessment of the prognostic effect of ALDH1 expression was stratified according to age and systemic treatment. Results: Complete lack of expression of ALDH1 was found in 40% of tumors. With increasing age more tumors showed complete absence of ALDH1 expression (P .001). In patients aged 65 years, ALDH1 status was not associated with any clinical outcome. Conversely, in patients aged 65 years, ALDH1 positivity was an independent risk factor of worse outcome for relapse free period (hazard ratio = 1.71 (95% CI, 1.09 to 2.68); P = .021) and relative survival (relative excess risks of death = 2.36 (95% CI, 1.22 to 3.68); P = .016). Ten-year relative survival risk was 57% in ALDH1-positive patients compared to 83% in A