ALDH1 Cancer Stem Cell Marker as a Prognostic Factor in Triple-Negative Breast Cancer

Abstract

<jats:p>Breast cancer is the most common cancer with an increasing incidence in Asia. About 20% of all breast cancers are triple-negative breast cancers (TNBCs). BCSC is a subset of tumor cells that has stem cell-like characteristics, such as a high capacity for self-renewal and tumor initiation, which implies that BCSC may cause aggressiveness of TNBC. ALDH1 has a role in early stem cell differentiation through its function in the oxidation of retinol to retinoic acid, proposed to be a strong candidate for breast cancer stem cells. Various studies have shown that ALDH1 is one of the markers of CSC that can be used as a prognosis indicator because it can be a biological marker for poor prognostic factors in TNBC. This study assessed the prognostic survival rate with a retrospective cohort method in TNBC patients. A total of 54 of 55 patients treated at RSCM were tested for the expression of ALDH1 through an immunohistochemistry assay of breast cancer tissue using ALDH1 staining. Survival analysis was done to obtain the prognostic data of ALDH1. Positive ALDH1 expression was obtained at 38.89% in TNBC patients. One-year survival and three years of survival in TNBC patients with positive ALDH1 expression were 42.9% and 33.3%, respectively. In this study, ALDH1 can be used as a poor survival prognostic factor with HR 2.636 and <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mi>p</mml:mi></mml:math> value 0.013. The conclusion of this study is that ALDH1 can be used as a poor prognostic factor in TNBC patients although it cannot be an independent prognostic factor.</jats:p>

Transcriptional Expressions of ALDH1A1/B1 as Independent Indicators for the Survival of Thyroid Cancer Patients

“…We observed that the regulatory functions of ALDH1A1 and ALDH1B1 in thyroid cancer were involved in poor outcome in patients and inhibition of TILs. ALDH1 has been reported to play a role in promoting triplenegative breast cancer progression and enhanced drug resistance in a Notch receptor 4 (NOTCH4)-dependent manner (32,33). Ciccone et al (31) observed that overexpression of ALDH1A1 was significantly associated with Vascular endothelial growth factor (VEGF)-mediated angiogenesis by retinoic acid/ Hypoxiainducible factor (HIF)-1a signal.…”

“…ALDH1 has been reported to play a role in promoting triple-negative breast cancer progression and enhanced drug resistance in a Notch receptor 4 (NOTCH4)-dependent manner ( 32 , 33 ). Ciccone et al.…”

The most likely but largely ignored triggering factor for breast (or all) cancer invasion

“…Since p63 belongs to the p53 tumor suppressor family, and is normally expressed in the nucleus of the ME cells [151,152], an aberrant expression level or subcellular localization of p63 may signify the predisposition of cancer susceptibility or mutated suppressing genes. Previous studies have consistently revealed that the loss or cytoplasmic expression of p63 is associated with elevated stem cells, enhanced cell migration and metastasis, and increased mortality [153][154][155] [177][178][179][180][181][182][183][184][185][186][187][188][189][190][191]. Thus, the administration of these molecules, or stem cell specific inducers and stimulators to patients with a high frequency of degenerations and focal disruptions (Figure 11, 14) may facilitate the restoration of the normal replenishment and functions of the MECLs.…”

Cancer stem cells: Signaling pathways and therapeutic targeting

“…22,23 • CD117 has been specified as a leukemia CSC marker, oral squamous cell carcinoma ovarian tumors, and gastrointestinal stromal tumor. [24][25][26] • Various CSC markers have been proposed with slight alterations in protein composition and structure in breast, prostate, brain, lung, esophageal, pancreatic, colon, head, and neck cancers 27,28 (Details in Table 1).…”