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BMC Cancer
Published in: BMC Cancer 1/2012

Open Access 01-12-2012 | Research article

Age determines the prognostic role of the cancer stem cell marker aldehyde dehydrogenase-1 in breast cancer

Authors: J Sven D Mieog, Esther M de Kruijf, Esther Bastiaannet, Peter JK Kuppen, Anita Sajet, Anton JM de Craen, Vincent THBM Smit, Cornelis JH van de Velde, Gerrit-Jan Liefers

Published in: BMC Cancer | Issue 1/2012

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Abstract

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.
Appendix
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Metadata
Title
Age determines the prognostic role of the cancer stem cell marker aldehyde dehydrogenase-1 in breast cancer
Authors
J Sven D Mieog
Esther M de Kruijf
Esther Bastiaannet
Peter JK Kuppen
Anita Sajet
Anton JM de Craen
Vincent THBM Smit
Cornelis JH van de Velde
Gerrit-Jan Liefers
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2012
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/1471-2407-12-42

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