Date of Award

January 2016

Document Type


Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Vasilis Vasiliou



Background & Hypothesis

It has become clear that ALDH1 genes are involved in the pathobiology of various human cancers. Several lines of evidence indicated that ALDH1 gene expression in tumors may be associated with clinical prognosis outcomes. This hypothesis of our study is that ALDH1 genes may be used to predict human cancer prognosis. In order to test this hypothesis, a systematic review of published articles, a meta-analysis using Random-Effects model was conducted to assess the association between ALDH1 genes and clinicopathological features as well as survival outcomes.


Using PubMed, EMBASE and Web of Science, this study identified original English researches targeted for association between ALDH1 genes and cancer prognosis for more than 20 patients during survival analysis follow-up. This meta-analysis included original studies that evaluated a major clinical outcomes (overall survival, disease progression, recurrence, and metastasis) in agnostic format for a variety of cancer types and ALDH1 genes. Association of ALDH1 expression and clinicopathological outcomes were evaluated using the Review Manager 5.3 software.


One hundred and twenty one original researches were eligible for inclusion in this meta-analysis. ALDH1 expression was significantly associated with poor overall survival of breast cancer, colon cancer, non-small cell lung cancer, and ovarian cancer. ALDH1 expression was also associated with poor prognosis of disease-free survival of breast cancer, non-small cell lung cancer, and rectal cancer. This meta-analysis showed no association of ALDH1 expression with prognosis of esophageal squamous carcinoma and Head and Neck Squamous Cell Carcinoma (HNSCC).


Expression of ALDH1 genes is associated with poor prognosis of breast cancer, colon cancer, non-small cell lung cancer, ovarian cancer and rectal cancer.


This thesis is restricted to Yale network users only. It will be made publicly available on 05/06/2018