TY - JOUR
T1 - Age determines the prognostic role of the cancer stem cell marker aldehyde dehydrogenase-1 in breast cancer
AU - Mieog, J. Sven D.
AU - de Kruijf, Esther M.
AU - Bastiaannet, Esther
AU - Kuppen, Peter J.K.
AU - Sajet, Anita
AU - de Craen, Anton J.M.
AU - Smit, Vincent T.H.B.M.
AU - van de Velde, Cornelis J.H.
AU - Liefers, Gerrit Jan
N1 - Funding Information:
This research was partly supported by a grant from the Dutch Cancer Society (KWF 2007-3968).
PY - 2012/1/26
Y1 - 2012/1/26
N2 - 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 ALDH1-negative patients.Conclusion: ALDH1 expression and its prognostic effect are age-dependent. Our results support the hypothesis that breast cancer biology is different in elderly patients compared to their younger counterparts and emphasizes the importance of taking into consideration age-specific interactions in breast cancer research.
AB - 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 ALDH1-negative patients.Conclusion: ALDH1 expression and its prognostic effect are age-dependent. Our results support the hypothesis that breast cancer biology is different in elderly patients compared to their younger counterparts and emphasizes the importance of taking into consideration age-specific interactions in breast cancer research.
KW - ALDH1
KW - Age
KW - Breast cancer
KW - Prognostic factor part of this work has been presented at the american association for cancer research (AACR) annual meeting 2011
UR - http://www.scopus.com/inward/record.url?scp=84856086583&partnerID=8YFLogxK
U2 - 10.1186/1471-2407-12-42
DO - 10.1186/1471-2407-12-42
M3 - Article
C2 - 22280212
AN - SCOPUS:84856086583
SN - 1471-2407
VL - 12
JO - BMC Cancer
JF - BMC Cancer
M1 - 42
ER -