Study on aldehyde dehydrogenase-1 tumor cells in invasive micropapillary carcinoma of the breast

Abstract

Objective To investigate the expression of tumor stem cell marker aldehyde dehydrogenase -1 （ALDH-1）in primary tumor and lymph node metastases of lymph node-positive invasive micropapillary carcinoma （ IMPC） of breast and its clinical significance .Methods The expression , location and distribution of ALDH-1 were examined by immunohistochemical staining in 103 cases with lymph node metastasis of IMPC and 110 cases with lymph node metastasis of invasive ductal carcinoma not otherwise specified （ IDC-NOS） without preoperative chemotherapy and radiotherapy , and their relationship with clinicopathological characteristics and prognostic sig-nificance was analyzed .Results （ 1 ） The positive expression rate of ALDH-1 was significantly higher in IMPC group of primary tumor and lymph node metastases （37.9% in primary tumor, 39/103 cases;47.6% in lymph node metastases, 49/103 cases）than in IDC-NOS group（21.8% in primary tumor, 24/110 cases; 23.6% in lymph node metastases, 26/110 cases）（P<0.05）.（2）Expression of ALDH-1 had a significantly positive corre-lation with tumor size , histological grade , lymph node metastasis , ER-negative status , PR-negative status , and HER2 overexpression in primary tumor and lymph node metastases of IMPC （P<0.05）.（3）The disease-free sur-vival of IMPC group patients was significantly shorter than that of IDC-NOS group patients（P=0.003）.In IPMC patients with lymphode metastases , the disease-free survival of patients with ALDH-1 positive in primary tumor and lymph node was significantly lower than patients with ALDH-1 negative expression （P<0.05）.In multivari-ate analysis, positive expression of ALDH-1 in metastatic lesions was associated with worse prognosis （ P =0.005）.Conclusion ALDH-1 can be used as an independent factor for predicting prognosis of patients with lymph node-positive breast IMPC and the existence of stem cells in IMPC tumor cells may represent high IMPC lymphatic invasion , lymph node metastasis and high resistance . Key words: Breast invasive micro papillary carcinoma; Stem cells; Primary foci; Lymph node metastases