Open Journal Systems

The correlation between aldehyde dehydrogenase-1A1 level and tumor shrinkage after preoperative chemoradiation in locally advanced rectal cancer

Rhandyka Rafli ()
Soehartati A Gondhowiardjo ()
Adang Bachtiar Kantaatmadja ()
Sahat Matondang ()
Ening Krisnuhoni ()


This study was performed to determine the correlation between aldehyde dehydrogenase-1A1 (ALDH1A1) level and tumor shrinkage after chemoradiation in locally advanced rectal cancer. This is a retrospective study of 14 locally advanced rectal cancer patients with long course neoadjuvant chemoradiation. ALDH1A1 level was measured using ELISA from paraffin embedded tissue. Tumor shrinkage was measured from computed tomography (CT) scan or magnetic resonance imaging (MRI) based on Response Evaluation Criteria in Solid Tumor v1.1 (RECIST v1.1). The mean of ALDH1A1 level was 9.014 ± 3.3 pg/mL and the mean of tumor shrinkage was 7.89 ± 35.7%. Partial response proportion was 28.6%, stable disease proportion was 50% and progressive disease proportion was 21.4%. There was a significant strong negative correlation (r = –0.890, p < 0.001) between ALDH1A1 and tumor shrinkage. In conclusion, tumor shrinkage in locally advanced rectal cancer after preoperative chemoradiation was influenced by ALDH1A1 level. Higher level of ALDH1A1 suggests decreased tumor shrinkage after preoperative chemoradiation.


ALDH1A1 ; chemoradiation ; rectal cancer

Full Text:



Ferlay J, Soerjomataram I, Ervik M, et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC Cancer Base. No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer. 2013. Available from: http://globocan.iarc.f.

Barrera G. Oxidative stress and lipid peroxidation products in cancer progression and therapy. ISRN Oncol 2012; 2012: 137289. doi: 10.5402/2012/137289

Vasiliou V, Nebert DW. Analysis and update of the human aldehyde dehydrogenase (ALDH) gene family. Hum Genomics 2005; 2(2): 138–143.

Lindahl R. Aldehyde dehydrogenases and their role in carcinogenesis. Crit Rev Biochem Mol Bio 1992; 27(4-5): 283–335. doi: 10.3109/10409239209082565

Ginestier C, Hur MH, Charafe-Jauffret E, et al. ALDH1 is a marker of normal and malignant human mammary stem cells and a predictor of poor clinical outcome. Cell Stem Cell 2007; 1(5): 555–567. doi: 10.1016/j.stem.2007.08.014

Marcato P, Dean CA, Giacomantonio CA, et al. Aldehyde dehydrogenase: its role as a cancer stem cell marker comes down to the specific isoform. Cell Cycle 2011; 10(9): 1378–1384. doi: 10.4161/cc.10.9.15486

Prasmickaite L, Engesæter BØ, Skrbo N, et al. Aldehyde dehydrogenase (ALDH) activity does not select for cells with enhanced aggressive properties in malignant melanoma. PLoS One 2010; 5(5): e10731. doi: 10.1371/journal.pone.0010731

Avoranta ST, Korkeila EA, Ristamaki RH, et al. ALDH1 expression indicates chemotherapy resistance and poor outcome in node-negative rectal cancer. Hum Pathol 2013; 44(6): 966–974. doi: 10.1016/j.humpath.2012.10.003

Oh PS, Patel VB, Sanders MA, et al. Schlafen-3 decreases cancer stem cell marker expression and autocrine/juxtacrine signaling in FOLFOX-resistant colon cancer cells. Am J Physiol Gastrointest Liver Physiol 2011; 301(2): G347–G355. doi: 10.1152/ajpgi.00403.2010

Vogler T, Kriegl L, Horst D, et al. The expression pattern of aldehyde dehydrogenase 1 (ALDH1) is an independent prognostic marker for low survival in colorectal tumors. Exp Mol Pathol 2012; 92(1):111–117. doi: 10.1016/j.yexmp.2011.10.010

Ishii H, Iwatsuki M, Ieta K, et al. Cancer stem cells and chemoradiation resistance. Cancer Sci 2008; 99(10): 1871–1877. doi: 10.1111/j.1349-7006.2008.00914.x

Kahlert C, Gaitzsch E, Steinert G, et al. Expression analysis of aldehyde dehydrogenase 1A1 (ALDH1A1) in colon and rectal cancer in association with prognosis and response to chemotherapy. Ann Surg Oncol 2012; 19(13): 4193–4201. doi: 10.1245/s10434-012-2518-9

Eisenhauer EA, Therasse P, Bogaerts J, et al. New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1). Eur J Cancer 2009; 45(2): 228–247. doi: 10.1016/j.ejca.2008.10.026

Hessman CJ, Bubbers EJ, Billingsley KG, et al. Loss of expression of the cancer stem cell marker aldehyde dehydrogenase 1 correlates with advanced-stage colorectal cancer. Am J Surg 2012; 203(5): 649–653. doi: 10.1016/j.amjsurg.2012.01.003

Balicki D. Moving forward in human mammary stem cell biology and breast cancer prognostication using ALDH1. Cell Stem Cell 2007; 1(5): 485–487. doi: 10.1016/j.stem.2007.10.015

Xu SL, Zeng DZ, Dong WG, et al. Distinct patterns of ALDH1A1 expression predict metastasis and poor outcome of colorectal carcinoma. Int J Clin Exp Pathol 2014; 7(6): 2976–2986.

Lim JS, Kim D, Baek SE, et al. Perfusion MRI for the prediction of treatment response after preoperative chemoradiotherapy in locally advanced rectal cancer. Eur Radiol 2012; 22(8): 1693–1700. doi: 10.1007/s00330-012-2416-3



  • There are currently no refbacks.

Copyright (c) 2018 Rhandyka Rafli, Soehartati A Gondhowiardjo, Adang Bachtiar Kantaatmadja, Sahat Matondang, Ening Krisnuhoni

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.