Lobna Abdelaziz - Department of Clinical Oncology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
Ola Harb - Department of Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
Abeer Abdelbary - Department of Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
Amrallah Mohammed - Department of Medical Oncology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
Hend Elkalla - Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Background: Aldehyde dehydrogenase ۱ (ALDH۱) is an enzyme accountable for the detoxification of aldehydes. Sex-determining region Y-box ۹ (SOX-۹) plays a role in many biological and pathological processes. In this study, we aimed to evaluate the prognostic significance of ALDH۱ and SOX۹ expression in early breast cancer.Method: The expression of ALDH۱ and SOX-۹ was evaluated through immunohistochemistry derived from ۵۰ eligible patients with early breast cancer included in the current prospective cohort study.Results: Positive expression of ALDH۱ and SOX-۹ were detected in ۲۹ (۵۸%) and ۳۴ (۶۸%) patients, respectively. The positive expressions of both markers were statistically significant associated with increasing the stage, lymph nodes metastasis, high Ki۶۷ labeling index, and molecular subtypes (P < ۰.۰۰۱), along with with the biological markers; estrogen receptors, progesterone receptors, and human epidermal growth factor receptor ۲ over-expressions, and large tumor size (P = ۰.۰۳۹, P = ۰.۰۲۲, P = ۰.۰۲۴ and P = ۰.۰۰۳ for ALDH۱ expression and P = ۰.۰۱۲, P = ۰.۰۰۷, P = ۰.۰۰۴ , and P = ۰.۰۰۲ for SOX-۹ expression, respectively). There is a significant positive association between the expression of ALDH۱ and SOX-۹, r (correlation coefficient) = +۰.۸۰۶ (P < ۰.۰۰۱). Local recurrence was associated with the positive expression of ALDH۱ only (P = ۰.۰۴۵) and the disease progression was statistically significant and associated with the positive expression of both ALDH۱ and SOX-۹ (P = ۰.۰۳۸, P = ۰.۰۲۳, respectively). There was significant association of positive expression of SOX-۹ with reduced ۳-y disease-free survival (P = ۰.۰۳۹).Conclusion: Positive expression of ALDH-۱ and SOX۹ were associated with aggressive histopathological features and poor outcome in early breast cancer and can be considered potential prognostic markers in this group of patients.

Early breast cancer, Neoplastic stem cells, Aldehyde dehydrogenase ۱, SOX۹, Prognosis