J Breast Cancer.  2015 Dec;18(4):347-355. 10.4048/jbc.2015.18.4.347.

Prognostic Impact and Clinicopathological Correlation of CD133 and ALDH1 Expression in Invasive Breast Cancer

• Kim SJ
• Kim YS
• Jang ED
• Seo KJ
• Kim JS

• KMID: 2176283
• DOI: http://doi.org/10.4048/jbc.2015.18.4.347

Abstract

PURPOSE
CD133 and aldehyde dehydrogenase 1 (ALDH1) expression are reliable poor-prognosis markers associated with the presence of adverse biomarkers and subtypes of breast cancer. The aim of our study was to investigate and compare the clinical impact of CD133 and ALDH1 expression in invasive breast cancer.
METHODS
A total of 291 consecutive patients with invasive breast cancer who underwent breast cancer operations from 2005 to 2010 at a single institution were included in this retrospective review. CD133 and ALDH1 expression were determined by immunohistochemistry.
RESULTS
CD133 and ALDH1 expression were positive in 24.7% and 22.0% of the patients, respectively, and were associated with tumor size, cancer stage, estrogen receptor negativity, nonluminal subtype, triple-negative breast cancer, and recurrence. CD133 expression was significantly associated with lymph node metastasis, progesterone receptor negativity, human epidermal growth factor receptor 2 positivity, chemotherapy, and poor disease-free (p=0.002) and overall survival (p=0.014), but ALDH1 expression was not. Cancer stage (p<0.001) was an independent prognostic factor for disease-free survival in multivariate analysis. Cancer stage (p<0.001) and receipt of radiotherapy (p=0.045) were independent prognostic factors for overall survival in multivariate analysis.
CONCLUSION
CD133 or the combination of CD133 and ALDH1 expression were more widely associated with the presence of adverse biomarkers and subtypes of breast cancer, compared to ALDH1 expression alone, and these markers may have a potential predictive role and be a helpful tool in the management for patients with invasive breast cancer.

Keyword

Aldehyde dehydrogenase 1; Breast neoplasms; CD133 antigen; Prognosis

MeSH Terms

Aldehyde Dehydrogenase
Biomarkers
Breast Neoplasms*
Breast*
Disease-Free Survival
Drug Therapy
Estrogens
Humans
Immunohistochemistry
Lymph Nodes
Multivariate Analysis
Neoplasm Metastasis
Prognosis
Radiotherapy
Receptor, Epidermal Growth Factor
Receptors, Progesterone
Recurrence
Retrospective Studies
Triple Negative Breast Neoplasms
Aldehyde Dehydrogenase
Estrogens
Receptor, Epidermal Growth Factor
Receptors, Progesterone

Figure

• 

  Figure 1 Immunohistochemical stainings of CD133 protein. (A) CD133 was expressed as 0, negative (IHC stain, ×400). (B) CD133 was expressed as 1+, weakly positive (IHC stain, ×400). (C) CD133 was expressed as 2+, intermediate positive (IHC stain, ×400). (D) CD133 was expressed as 3+, strongly positive (IHC stain, ×200).

• 

  Figure 2 Immunohistochemical staining of aldehyde dehydrogenase 1 (ALDH1) protein. (A) ALDH1 was expressed as 0, negative (IHC stain, ×200). (B) ALDH1 was expressed as 1+, weakly positive (IHC stain, ×400). (C) ALDH1 was expressed as 2+, intermediate positive (IHC stain, ×200). (D) ALDH1 was expressed as 3+, strongly positive (IHC stain, ×200).

• 

  Figure 3 Kaplan-Meier survival analysis of CD133 expression with disease-free survival (DFS) and overall survival (OS). Positive expressions of CD133 antigen have significant negative association with both DFS (A) (p=0.002) and OS (B) (p=0.014).

• 

  Figure 4 Kaplan-Meier survival analysis of combined CD133/ALDH1 expression with disease-free survival (DFS) and overall survival (OS). Positive expressions of combined CD133/ALDH1 antigen have significant negative association with both DFS (A) (p=0.003) and OS (B) (p=0.002).

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