Evaluation of the Role of ALDH1 as Cancer Stem Cell Marker in Colorectal Carcinoma: An Immunohistochemical Study
Published: January 1, 2017 | DOI: https://doi.org/10.7860/JCDR/2017/22671.9291
Nanis Shawky Holah, Hayam Abd-El-Samie Aiad, Nancy Yousif Asaad, Enas Abobakr Elkhouly, Ayat Gamal Lasheen
1. Department of Pathology, Faculty of Medicine, Menoufia University, Shebien ElKom, Menoufia, Egypt.
2. Professor, Department of Pathology, Faculty of Medicine, Menoufia University, Shebien ElKom, Menoufia, Egypt.
3. Professor, Department of Pathology, Faculty of Medicine, Menoufia University, Shebien ElKom, Menoufia, Egypt.
4. Department of Oncology, Faculty of Medicine, Menoufia University, Shebien ElKom, Menoufia, Egypt.
5. Department of Pathology, Faculty of Medicine, Menoufia University, Shebien ElKom, Menoufia, Egypt.
Correspondence
Dr. Nanis Shawky Holah,
M.D, Department of Pathology, Faculty of Medicine, Menoufia University, Shebien ElKom, Menoufia, Egypt.
E-mail: shawkyholah@yahoo.com
Introduction: Colorectal Carcinoma (CRC) is the third most commonly diagnosed cancer in males. Stem Cells (SC) may be involved in tumour growth, including colon cancer. Aldehyde Dehydrogenase 1 (ALDH1) is a detoxifying enzyme that might modulate SC proliferation.
Aims: To evaluate the immunohistochemical expression of ALDH1 as stem cell marker in the pathogenesis of colorectal carcinoma.
Materials and Methods: This retrospective study included 71 colorectal specimens (49 colorectal carcinoma, 13 adenoma and 9 normal cases) that were collected from Pathology Department, Faculty of Medicine, Menoufia University during the period from 2011 to 2015. All cases were stained by ALDH 1 antibody. Survival data were available for 31cases.
Results: There was a statistical significant association between epithelial positivity of ALDH1 and younger age (p=0.003), right sided tumour (p=0.038), presence of lymph node invasion (p= 0.04), ulcerating gross picture (p=0.01) and presence of vascular invasion (p=0.05). Moreover, there was statistical significant association between stromal positivity of ALDH1 and smaller tumour size (p=0.03) and inverse association between stromal expression of ALDH1 and grade of tumour (p=0.000) and perineural invasion (p= 0.05). Furthermore, there was an inverse significant relation between CD44 and ALDH1 expression (p=0.001). Univariate recurrence free survival analysis revealed the bad prognostic impact of high grade (p=0.03) and female sex (p=0.02) on patient outcome.
Conclusion: Epithelial expression of ALDH1 might be associated with poor prognosis while its stromal expression might be associated with good prognosis.
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