The role of ALDH1A1 in contributing to breast tumour aggressiveness: A study conducted in an African population

Gyan, Eric; Green, Andrew; Ahenkorah-Fondjo, Linda; Jackson, Andrew; Toss, Michael S.; Akakpo, Patrick Kafui; Derkyi-Kwarteng, Leonard; Rahman, Ganiyu A.; Owiredu, William

Abstract

Aldehyde dehydrogenase 1 member A1 (ALDH1A1) is one of the most well studied breast cancer stem cells. Its expression has been associated with poor clinicopathological features and clinical outcomes in several studies. This paper studies the expression of ALDH1A1 and its combination with CD44+/CD24−/low breast cancer stem cell and their association with clinicopathological parameters and molecular subtypes.

Method

Tissue Microarray was constructed from 222 Formalin Fixed Paraffin Embedded (FFPE) breast cancer tissues. The expression of ALDH1A1, CD44 and CD24 were assessed by Immunohistochemistry (IHC). The association of ALDH1A1 and its association with clinicopathological parameters, molecular subtypes, CD44 and CD24 were studied in an African population. The association between CD44+/CD24−/low/ALDH1+ and the clinicopathological phenotypes were also studied.

Results

A high ALDH1A1 expression of 90% was recorded in this study. No association was found between ALDH1A1 and clinicopathological parameters. ALDH1A1 was positively associated with CD24 (r = 0.228, OR-4.599 95% CI- 1.751–12.076, p = 0.001) and CD44 (r = 0.228, OR-5.538 95%CI- 1.841–16.662, p = 0.001) but not associated with CD44+/CD24−/low (r = 0.134, OR- 2.720 95%CI- 0.959–7.710, p = 0.052). CD44+/CD24−/ALDH1+ however had significant associations with Age (p- 0.020, r = 0.161, OR- 2.771, 95%CI 1.147–6.697), Gender (p = 0.004, OR- 15.333 95%CI 1.339–175.54), Tumour grade (p = 0.005, r = 0.197, OR-3.913 95%CI 1.421–10.776) and clinical prognostic staging (p = 0.014, r = 0.182, OR-3.028 95%CI- 1.217–7.536). There was no association between CD44+/CD24−/ALDH1+ and the molecular subtypes.

Conclusion

The high expression of ALDH1A1 in breast cancer makes it an important target for targeted therapy. This study further confirms the increased tumourigenicity of CD44+/CD24−/ALDH1+ combination phenotype and its association with increased tumour grade and clinical prognostic stage. Survival studies of ALDH1A1 and other breast cancer stem cells in African populations are strongly recommended to help further understand their effect on tumour aggressiveness.

Citation

Gyan, E., Green, A., Ahenkorah-Fondjo, L., Jackson, A., Toss, M. S., Akakpo, P. K., …Owiredu, W. (2021). The role of ALDH1A1 in contributing to breast tumour aggressiveness: A study conducted in an African population. Annals of Diagnostic Pathology, 51, Article 151696. https://doi.org/10.1016/j.anndiagpath.2020.151696

• Journal Article Type: Article
• Acceptance Date: Jan 1, 2021
• Online Publication Date: Jan 14, 2021
• Publication Date: 2021-04
• Deposit Date: Jun 22, 2021
• Publicly Available Date: Jan 15, 2022
• Journal: Annals of Diagnostic Pathology
• Print ISSN: 1092-9134
• Electronic ISSN: 1532-8198
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 51
• Article Number: 151696
• DOI: https://doi.org/10.1016/j.anndiagpath.2020.151696
• Keywords: Pathology and Forensic Medicine; General Medicine
• Public URL: https://nottingham-repository.worktribe.com/output/5718920
• Publisher URL: https://www.sciencedirect.com/science/article/abs/pii/S1092913420302434?via%3Dihub
• Additional Information: This article is maintained by: Elsevier; Article Title: The role of ALDH1A1 in contributing to breast tumour aggressiveness: A study conducted in an African population; Journal Title: Annals of Diagnostic Pathology; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.anndiagpath.2020.151696; Content Type: article; Copyright: © 2021 Elsevier Inc. All rights reserved.