Abstract
BackgroundAldehyde dehydrogenase 1 family member A1 (ALDH1A1) is a cancer stem cell marker, and its expression correlates with prognosis in a number of malignancies. The aim of this study is to determine the relationship of ALDH1A1 expression with clinicopathological parameters and prognosis in gastric cancer.MethodsALDH1A1 and matrix metallopeptidase 9 (MMP-9) was evaluated by immunohistochemistry in 216 gastric carcinoma samples. The association between expression of ALDH1A1 and MMP-9, clinicopathological parameters, and prognosis of gastric cancer was examined.ResultsALDH1A1 protein expression was significantly associated with depth invasion, lymph node metastasis and stage of disease (all P < 0.05). Both univariate and multivariate analyses revealed that ALDH1A1 was an independent prognostic factor for both overall survival (OS) and recurrence-free survival (RFS) (both P < 0.001). Furthermore, ALDH1A1 overexpression was associated with poor prognosis in patients subgroups stratified by tumor size, depth invasion and lymph node metastasis. Moreover, ALDH1A1 was significantly correlated with MMP-9 among 216 gastric cancer tissues (P < 0.001). Patients who had ALDH1A1 overexpression, in which tumor cells displayed high invasiveness, had poor OS and shorter RFS.ConclusionALDH1A1 plays an important role in tumor aggressiveness and prognosis, and may act as a promising target for prognostic prediction.
Highlights
Aldehyde dehydrogenase 1 family member A1 (ALDH1A1) is a cancer stem cell marker, and its expression correlates with prognosis in a number of malignancies
The association of ALDH1A1 with clinicopathological variables To elucidate the biological significance of ALDH1A1 in gastric cancer, we examined the immunohistochemical expression of ALDH1A1 in gastric cancer tissues (Figure 1)
Our analyses showed that the level of ALDH1A1 in gastric cancer was significantly correlated with depth of invasion (P < 0.001), lymph node metastasis (P < 0.001), and stage of disease (P < 0.001), but was not associated with gender, age, tumor size, tumor site and grade of differentiation (P > 0.05) (Table 1)
Summary
Aldehyde dehydrogenase 1 family member A1 (ALDH1A1) is a cancer stem cell marker, and its expression correlates with prognosis in a number of malignancies. The molecular mechanism involved in the development of gastric cancer remains unclear. Each subunit contains a catalytic domain, a ALDH1A1 is a cytosolic enzyme responsible for oxidizing a variety of intracellular aldehydes to carboxylic acids [10]. It plays an important role in the detoxification of peroxidic aldehydes produced by ultraviolet light absorption, protecting the lens of the eye. The role of ALDH1A1 on the prognosis of patients with gastric cancer remains unclear
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