Study on aldehyde dehydrogenase-1 tumor cells in invasive micropapillary carcinoma of the breast / 中华内分泌外科杂志

ABSTRACT

Objective To investigate the expression of tumor stem cell marker aldehyde dehydrogenase -1 (ALDH-1)in primary tumor and lymph node metastases of lymph node-positive invasive micropapillary carcinoma ( IMPC) of breast and its clinical significance .Methods The expression , location and distribution of ALDH-1 were examined by immunohistochemical staining in 103 cases with lymph node metastasis of IMPC and 110 cases with lymph node metastasis of invasive ductal carcinoma not otherwise specified ( IDC-NOS) without preoperative chemotherapy and radiotherapy , and their relationship with clinicopathological characteristics and prognostic sig-nificance was analyzed .Results ( 1 ) The positive expression rate of ALDH-1 was significantly higher in IMPC group of primary tumor and lymph node metastases (37.9% in primary tumor, 39/103 cases;47.6% in lymph node metastases, 49/103 cases)than in IDC-NOS group(21.8% in primary tumor, 24/110 cases; 23.6% in lymph node metastases, 26/110 cases)(P<0.05).(2)Expression of ALDH-1 had a significantly positive corre-lation with tumor size , histological grade , lymph node metastasis , ER-negative status , PR-negative status , and HER2 overexpression in primary tumor and lymph node metastases of IMPC (P<0.05).(3)The disease-free sur-vival of IMPC group patients was significantly shorter than that of IDC-NOS group patients(P=0.003).In IPMC patients with lymphode metastases , the disease-free survival of patients with ALDH-1 positive in primary tumor and lymph node was significantly lower than patients with ALDH-1 negative expression (P<0.05).In multivari-ate analysis, positive expression of ALDH-1 in metastatic lesions was associated with worse prognosis ( P =0.005).Conclusion ALDH-1 can be used as an independent factor for predicting prognosis of patients with lymph node-positive breast IMPC and the existence of stem cells in IMPC tumor cells may represent high IMPC lymphatic invasion , lymph node metastasis and high resistance .