Prognostic Impact of ALDH1 Expression in Transitional Cell Carcinoma of the Renal Pelvis.

AIM: To investigate the clinical significance of aldehyde dehydrogenase 1 (ALDH1) expression in the assessment of the pathological outcomes and prognosis of carcinoma of the renal pelvis through examination of ALDH1 expression in pathological specimens.

MATERIALS AND

METHODS

A total of 114 patients with carcinoma of the renal pelvis who underwent radical nephroureterectomy at the First Hospital of Peking University between September 2004 and August 2007 with continuity in data were included in this study. The expression of ALDH1 was examined in pathological specimens via immunohistochemistry, and was statistically analyzed in combination with corresponding clinical and pathological information.

RESULTS

The pathological specimens from 37 patients (32.5%) exhibited positive ALDH1 expression, showing correlation with T stage (p=0.001) and G grade (p=0.010), as well as lymphatic and vascular infiltration (p=0.003), but these specimens did not correlate with tumor multi-focality (p=0.398). The univariate analysis showed that tumor grade (p=0.001) and ALDH1 positive expression (p<0.001), as well as lymphatic and vascular infiltration (p=0.017) correlated with prognosis, and this analysis also showed that tumour, node and metastasis (TNM) stage (p=0.085), as well as occurrence of multiple tumors (p=0.166) had no significant correlation with prognosis. Multivariate analysis indicated advanced G grade (p=0.006) and ALDH1 expression as independent predictive factors for poor prognosis. A significant correlation was observed between positive ALDH1 expression and tumor relapse following radical resection (p<0.001).

CONCLUSION

The cancer stem-like cell marker ALDH1 can be used as a predictive factor for adverse pathological outcomes and prognosis in transitional cell carcinoma. of the renal pelvis. Cancer stem cell theory plays an important role in the clinical study of transitional cell carcinoma of the upper urinary tract.