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. 2015 Dec;18(4):347-55.
doi: 10.4048/jbc.2015.18.4.347. Epub 2015 Dec 23.

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

Sung Jeep Kim  1 , Yong Seok Kim  1 , Eun Duok Jang  2 , Kyung Jin Seo  2 , Jeong Soo Kim  1
Affiliations

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

Sung Jeep Kim et al. J Breast Cancer. 2015 Dec.

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.

Keywords: Aldehyde dehydrogenase 1; Breast neoplasms; CD133 antigen; Prognosis.

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Conflict of interest statement

CONFLICT OF INTEREST: The authors declare that they have no competing interests.

Figures

Figure 1
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
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
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
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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