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The significance of Aldehyde dehydrogenase 1A1 expression in colorectal carcinoma

Background: Colorectal carcinoma (CRC) is the third most common cancer in the world constituting about 10% of all cancers. ALDH1A1 has been used as a stem cell marker, and plays important functional roles in stem cells. Expression of ALDH1A1 by cancer stem cells (CSCs) has been demonstrated in multiple types of cancers. Aim: This work aimed to evaluate ALDH1A1 expression in colorectal adenocarcinoma and determine the relation between ALDH1A1 expression and different clinico-pathological variables. Material and method: This is a selected retrospective study which included 50 different cases of colorectal adenocarcinoma. ALDH1A1 immunostaining was performed for all cases. Results: There was a highly significant statistical difference between ALDH1A1 expression in studied cases according to tumor site, lymph node metastasis and TNM stage (P value <0.01). Also, there was a significant statistical difference according to lymphovascular and perineural invasion (P value <0.05). Other clinico-pathological variables such as age, sex, tumor size, histopathological subtype, tumor grade, depth of tumor invasion and distant metastasis showed no significant statistical difference (P value >0.05). Conclusion: High ALDH1A1 expression was associated with right sided tumors, lymphovascular invasion, perineural invasion and lymph node metastasis in colorectal carcinoma. ALDH1A1 may play an important role in tumor invasion and lymph node metastasis and may work as a useful marker for prognosis of CRC.