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Aldehyde dehydrogenase 1 expression correlates with clinicopathologic features of patients with breast cancer: a meta-analysis.

A number of studies have investigated the relationship between aldehyde dehydrogenase 1 (ALDH1) expression and the clinical pathological features of the patients with breast cancer. However, conclusions reported by different parties seem to be inconsistent. We have reviewed published studies and carried out this meta-analysis to provide credible results. We searched PubMed for articles published in English until September 12, 2014. Our main analyses were focused on the association between ALDH1 and the clinical pathological features, such as age, tumor size, nodal status, lymphovascular invasion, histological grade, and the expression of ER, PR, and HER2 by meta-analysis methods. If heterogeneity was observed, we used random effects model to calculate the overall odds ratios, otherwise fixed effects model was used. Twenty-one eligible studies were included in the present meta-analysis. From the pooled analyses, there was significant association between ALDH1 expression and histological grade (low vs. intermediate: pooled OR = 1.51, 95% CI: 1.09-2.10, P = 0.01; intermediate vs. high: pooled OR = 1.86, 95% CI: 1.12-3.07, P = 0.02), ER expression (pooled OR = 0.41, 95% CI: 0.29-0.58, P < 0.00001), and PR expression (pooled OR = 0.56, 95% CI: 0.40-0.77, P = 0.0004). No clear correlation was found between ALDH1 expression and age, tumor size, lymph node (LN) metastasis, lynphovascular invasion, and HER2 expression (P > 0.05). Despite the inconsistency in the published reports, this meta-analysis provides credible evidence to support the association between ALDH1 and breast cancer. However, it is necessary to conduct large sample studies using standardized and well-matched controls.