雄激素受体在不同分子分型乳腺癌中的表达及临床病理意义

Significance of AR expression in different molecular classification of invasive breast cancer

目的:探讨雄激素受体(androgen receptor,AR)在不同分子分型的浸润性乳腺癌中的表达情况及相关性。方法:采用免疫组化方法检测635例浸润性乳腺癌标本中AR、雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)、人类表皮生长因子受体2(human epidermal growth factor receptor-type2,HER2)、Ki67蛋白的表达情况,分析AR在不同分子分型、组织学类型中的表达情况及相关分子之间的关系。结果:AR在Luminal A型、Luminal B型HER2阴性型、Luminal B型HER2阳性型、HER2过表达型及三阴型浸润性乳腺癌中的阳性率分别为74.5%(137/184)、56.1%(96/171)、67.8%(40/59)、56.0%(56/100)、32.2%(39/121),差异具有统计学意义(P<0.05);癌旁组织中AR阳性率为29.2%(158/542),明显低于癌组织中的表达,差异有统计学意义(P<0.05);AR蛋白表达在年龄分组及组织学分级中差异无统计学意义(P>0.05);AR阳性与ER、PR蛋白的阳性表达呈正相关(P<0.05),而与Ki-67的表达呈负相关(P<0.05)。结论:AR在不同分子分型乳腺癌中均有一定的表达,联合检测AR和ER、PR、HER2及Ki-67对判断乳腺癌的预后和选择治疗方案有一定价值。

Objective:To investigate the expression of androgen receptor(AR)and its correlation with molecular classifications in invasive breast cancer. Methods:The expressions of AR,estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor receptor-type2(HER2)and Ki67 in 635 cases of invasive breast cancer were detected with immunohistochemistry. The expression of AR and its correlation with molecular classifications,histologic grades and expressions of other related proteins was investigated and analyzed. Results:The positive rates of AR in luminal subtype A,luminal subtype B with negative HER2,luminal subtype B with positive HER2,HER2 over-expressing subtype,and triple negative subtype were 74.5%(137/184),56.1%(96/171),67.8%(40/59),56.0%(56/100),and 32.2%(39/121),respectively. The expression level of AR was lower in triple negative subtype than that in other subtypes(P<0.05). The expression of AR was significantly lower in adjacent tissues compared with invasive breast cancer tissues(P<0.05). There were no statistical difference in the expressions of AR with different age and different histologic grades(P>0.05). The expression of AR positively correlated with the expression of ER and PR(P<0.05),while negatively correlated with the expression of Ki-67(P<0.05). Conclusion:AR is expressed in different molecular classification of invasive breast cancer. Combined detection of AR and ER,PR,HER-2 may play an important role in predicting clinical outcomes of breast cancer.