title: Evaluation of aldehyde dehydrogenase 1 and transcription factors in both primary breast cancer and axillary lymph node metastases as a prognostic factor.
abstract: BACKGROUND
  Aldehyde dehydrogenase 1 (ALDH1) is a marker of breast cancer stem cells, and the expression of ALDH1 may be a prognostic factor of poor clinical outcome. The epithelial-mesenchymal transition may produce cells with stem-cell-like properties promoted by transcription factors. We investigated the expression of ALDH1 and transcription factors in both primary and metastatic lesions, and prognostic value of them in breast cancer patients with axillary lymph node metastasis (ALNM).
  
  
  METHODS
  Forty-seven breast cancer patients with ALNM who underwent surgery at Okayama University Hospital from 2002 to 2008 were enrolled. We retrospectively evaluated the levels of ALDH1 and transcription factors, such as Snail, Slug and Twist, in both primary and metastatic lesions by immunohistochemistry.
  
  
  RESULTS
  In primary lesions, the positive rate of ALDH1, Snail, Slug and Twist was 19, 49, 40 and 26%, respectively. In lymph nodes, that of ALDH1, Snail, Slug and Twist was 21, 32, 13 and 23%, respectively. The expression of ALDH1 or transcription factors alone was not significantly associated with a poor prognosis. However, co-expression of ALDH1 and Slug in primary lesions was associated with a shorter DFS (P = 0.009).
  
  
  CONCLUSIONS
  The evaluation of the co-expression of ALDH1 and transcription factors in primary lesions may be useful in prognosis of node-positive breast cancers.
authors.affiliation: Department of General Thoracic Surgery and Breast and Endocrine Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Kita-ku, Shikata-cho, Okayama, 700-8558, Japan. snufumin@yahoo.co.jp.
authors.forename: Maiko
authors.initials: M
authors.lastname: Ito
authors.affiliation: Department of General Thoracic Surgery and Breast and Endocrine Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Kita-ku, Shikata-cho, Okayama, 700-8558, Japan.
authors.forename: Tadahiko
authors.initials: T
authors.lastname: Shien
authors.affiliation: Department of Pathology, Okayama University Hospital, 2-5-1 Kita-ku, Shikata-cho, Okayama, 700-8558, Japan.
authors.forename: Masako
authors.initials: M
authors.lastname: Omori
authors.affiliation: Department of General Thoracic Surgery and Breast and Endocrine Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Kita-ku, Shikata-cho, Okayama, 700-8558, Japan.
authors.forename: Taeko
authors.initials: T
authors.lastname: Mizoo
authors.affiliation: Department of Breast and Endocrine Surgery, Okayama University Hospital, 2-5-1 Kita-ku, Shikata-cho, Okayama, 700-8558, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Iwamoto
authors.affiliation: Department of General Thoracic Surgery and Breast and Endocrine Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Kita-ku, Shikata-cho, Okayama, 700-8558, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Nogami
authors.affiliation: Department of Breast and Endocrine Surgery, Okayama University Hospital, 2-5-1 Kita-ku, Shikata-cho, Okayama, 700-8558, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Motoki
authors.affiliation: Department of General Thoracic Surgery and Breast and Endocrine Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Kita-ku, Shikata-cho, Okayama, 700-8558, Japan.
authors.forename: Naruto
authors.initials: N
authors.lastname: Taira
authors.affiliation: Department of General Thoracic Surgery and Breast and Endocrine Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Kita-ku, Shikata-cho, Okayama, 700-8558, Japan.
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Doihara
authors.affiliation: Department of General Thoracic Surgery and Breast and Endocrine Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Kita-ku, Shikata-cho, Okayama, 700-8558, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Miyoshi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000080924:Aldehyde Dehydrogenase 1 Family; D001365:Axilla / Q000473:pathology; D014408:Biomarkers, Tumor / Q000032:analysis / Q000378:metabolism; D001943:Breast Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology*; D018572:Disease-Free Survival; D058750:Epithelial-Mesenchymal Transition; D005260:Female; D006801:Humans; D007527:Isoenzymes / Q000032:analysis / Q000378:metabolism*; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology; D008875:Middle Aged; D009687:Nuclear Proteins / Q000032:analysis / Q000378:metabolism; D011379:Prognosis; D050697:Retinal Dehydrogenase / Q000032:analysis / Q000378:metabolism*; D000071250:Snail Family Transcription Factors / Q000032:analysis / Q000378:metabolism; D014157:Transcription Factors / Q000032:analysis / Q000378:metabolism*; D051879:Twist-Related Protein 1 / Q000032:analysis / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; D007527:Isoenzymes; D009687:Nuclear Proteins; C000604407:SNAI1 protein, human; D000071250:Snail Family Transcription Factors; C103173:TWIST1 protein, human; D014157:Transcription Factors; D051879:Twist-Related Protein 1; D000080924:Aldehyde Dehydrogenase 1 Family; C510223:ALDH1A1 protein, human; D050697:Retinal Dehydrogenase
keywords: ALDH1; Breast cancer; EMT; IHC; Transcription factors