Introduction: Prostate cancer in Indonesia is the 3 rd ranking cancer among males and the 5 th rank for their cancer mortality. Prognostic markers that can identify aggressive prostate cancer in early stages and help select appropriate therapy to finally reduce the mortality are therefore urgently needed. It has been suggested that stem cells in the prostate gland have a role in initiation, progression, and metastasis of cancer, although controversy continues to exist. Maintenance of normal stem cell or reserve cell populations in several epithelia including prostate has been shown to be regulated by p63 and alteration of p63 expression is considered to have an oncogenic role in prostate cancer. We hypothesize that the expression of cytoplasmic aberrance of p63 is associated with high ALDH1A1 expression as a cancer stem cell marker, thus leading to progression of prostate cancer. Methods: Using a cross-sectional study during two years (2009-2010), a total of 79 paraffin embedded tissues of benign prostatic hyperplasia, PIN prostatic intraepithelial neoplasia, low and high Gleason score prostate cancer were investigated using immunohistochemistry. Associations between cytoplasmic p63 and ALDH1A1, as well as with pathological diagnosis, were analyzed by Chi-Square test using SPSS 15.0. Links of both markers with cell proliferation rate (KI-67) and apoptotic rate (cleaved caspase 3) were also analyzed by Kruskal-Wallis test. Results: The mean age of patient at the diagnosis is 70.0 years. Cytoplasmic aberrance of p63 was associated with ALDH1A1 expression (p<0.001) and both were found to have significant relationships with pathological diagnosis (including Gleason score), (p=0.006 and p<0.001 respectively). Moreover, it was also found that higher levels of cytoplasmic p63 were significantly associated with the frequency of proliferating cells and cells undergoing apoptosis in prostate cancers (p=0.001 and p=0.016 respectively). Conclusion: p63 cytoplasmic aberrance is associated with high ALDH1A1 expression. These components are suggested to have an important role in prostate cancer progression and may be used as molecular markers.

Objective: To determine the association between Aldehyde Dehydrogenase 1A1 (ALDH1) expression and metastasis in prostate cancer. Material & methods: This study was a prospectivestudy in 45 patients diagnosed with prostate cancer in Sardjito General hospital. Patient characteristics and patient clinical data were recorded. Paraffin blocks of 45 patient surgery results were performed with immunohistochemical staining with monoclonal antibody of anti ALDH1A1 (EP1933Y, Biocare, dilution 1: 200). ALDH1 expression differences between prostate cancer without metastases and prostate cancer with metastasis was compared and analyzed with Chi-square. Results: This study involved 45 prostate cancer patients with median of age of 74 years. A high Gleason scores was found in 25 (55.6%) patients with prostate cancer and 24 (53.3%) patients had metastasis to the bone. The high expression of ALDH1 was found in 30 (66.7%) patients. The incidence of bone metastasis in patients with prostate cancer was associated with high levels of ALDH1 (p < 0.001, OR, 95% CI 17.88 (3.28-97.83) and was not associated with Gleason score (p = 0.316). Conclusion: Prostate cancer cells with high ALDH1A1 level increased the risk of the incidence of bone metastasis. ALDH1A1 level in prostate cancer cells can be considered as a predictor factor of the bone metastasis in prostate cancer.

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