Plasma level of cancer stem cell marker aldehyde dehydrogenase 1 (ALDH1) is higher in locally advance cervical cancer
This study is aimed to examine the plasma level of ALDH1 in early and locally advanced cervical cancer (CC) patients and to investigate its association with the presence of prognostic factors for recurrence in early stage. This is a cross-sectional study involving 82 patients with CC (33 patients with early stage IB-IIA and 49 patients with locally advance/LACC stage IIB-IVA) who were admitted to Gynecologic Oncology Clinic, Prof. dr. I G.N.G. Ngoerah Hospital Denpasar from September 2022 to April 2023. Prognostic factors for recurrence were recorded from early-stage CC after radical hysterectomy. Pre-treatment plasma level of ALDH1 was determined using ALDH1 ELISA kit (cat. no. E3259Hu). Plasma level of ALDH1 was significantly higher in patients with LACC as compared to early-stage CC (median: 7.0 vs. 4.3 ng/ml, p < 0.001). In early-stage CC, higher plasma level of ALDH1 was also associated with bulkier tumor mass (≥4 cm) (OR 9.2, 95 % CI 1.3-63.1, p = 0.001; threshold value 4.0 ng/ml, AUC 0.821, p-value = 0.002). However, plasma level of ALDH1 was not associated with the histologic subtype, the presence of LVSI, or status of the vaginal margins (p-value >0.05). Increasing plasma level of ALDH1 in CC patients was associated with more advance stage and bulkier tumor mass. Our finding suggests that in the clinical setting, evaluating the plasma level of ALDH1 may aid in assessing the progression of cervical cancer. Future study such as longer-term longitudinal study with larger sample size is needed to explore the association between ALDH1 expression and the clinical response to treatment (e.g., chemoradiation) or risk of recurrence in early-stage CC patients.