1. ALDH+/CD44+ cells in breast cancer are associated with worse prognosis and poor clinical outcome.
- Author
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Qiu, Yan, Pu, Tianjie, Guo, Peng, Wei, Bing, Zhang, Zhang, Zhang, Hongying, Zhong, Xiaorong, Zheng, Hong, Chen, Lina, Bu, Hong, and Ye, Feng
- Subjects
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CD44 antigen , *BREAST cancer treatment , *BREAST cancer prognosis , *TREATMENT effectiveness , *METASTASIS - Abstract
Background Breast cancer stem cells (BCSCs) play essential roles in tumor metastasis and contribute to remarkably negative clinical outcomes. Recently, aldehyde dehydrogenase (ALDH) and CD44 positivity (ALDH + /CD44 + ) was identified as a marker of BCSCs in vitro/in vivo studies. The aim of this study was to evaluate the prevalence of ALDH + /CD44 + cells in breast cancer and the association of these two markers with clinicopathological features and clinical outcomes. Materials and methods We investigated the prevalence of ALDH1A3 + /CD44 + cells in a cohort of 144 formalin-fixed, paraffin-embedded (FFPE) breast cancer tissues. The tissues were stained for ALDH1A3 and CD44 by single and dual immunohistochemistry (dIHC). The associations among the prevalence of ALDH1A3 + /CD44 + cells, the clinicopathological features and the clinical outcomes of the patients were also analyzed. Results ALDH1A3 + /CD44 + cells were present in 39 patients (27.1%). By the Mann–Whitney U test, the Pearson Chi-square test or Fisher's exact test, it was demonstrated that the prevalence of ALDH1A3 + /CD44 + cells was closely correlated with larger tumor size ( p = 0.001), nodal metastasis status ( p = 0.043), more advanced clinical stage ( p = 0.021) and distant metastasis after initial surgery ( p = 0.001). In a univariate survival analysis, the presence of ALDH1A3 + /CD44 + tumor cells had a significant negative association with both disease-free survival (DFS) and overall survival (OS) ( p DFS < 0.001; p OS < 0.001). The negative clinical outcomes in ALDH1A3 + /CD44 + tumors were further confirmed by a multivariate analysis using Cox proportional hazard models ( p DFS < 0.001, HR = 3.155; p OS = 0.001, HR = 3.193). This was also true with respect to the clinical treatment regimens of chemotherapy ( p DFS < 0.001; p OS = 0.001), radiotherapy ( p DFS = 0.004; p OS = 0.004), and endocrine therapy ( p DFS < 0.001; p OS < 0.001). Conclusion In summary, our results indicate that the prevalence of ALDH1A3 + /CD44 + tumor cells in breast cancer is significantly associated with worse prognostic factors and favors a poor prognosis. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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