不同ER、PR状态乳腺癌中AR的表达及其意义

Expression and significance of androgen receptor in breast carcinoma with different ER and PR status

目的探讨AR在不同ER、PR状态乳腺癌中的表达及意义。方法采用免疫组化方法检测AR、ER、PR在173例乳腺癌中的表达,依据结果分组:(1)AR状态分组:AR阳性组和AR阴性组;(2)ER、PR状态分组:En组(ER、PR均阴性)、Ep组[ER和(或)PR阳性];(3)AR、ER、PR联合分组:En-AR+(En组且AR阳性)、En-AR-(En组且AR阴性)、Ep-AR+(Ep组且AR阳性)、Ep-AR-(Ep组且AR阴性),其中En-AR-又称为均阴性组,其他三组统称为部分或完全阳性组。不同分组方法比较与临床病理特征的关系。结果Ep组AR阳性率62.8%(54/86),En组AR阳性率37.9%(33/87),两组差异有显著性(P=0.001),AR阳性组体积小、核分裂少、组织学分级低(P<0.05);En-AR-组表现为核分裂多、组织学分级高(P<0.01),此外En组内AR阳性者核分裂少、组织学分级低(P<0.05),Ep组内AR阳性者临床分期高(P=0.000),En-AR+、Ep-AR+、Ep-AR-比较均无差异。结论AR在不同激素状态乳腺癌中表达的意义不同,ER、PR均阴性乳腺癌表达AR者预后较好,ER、PR阳性乳腺癌表达AR者临床分期高。在选择针对性药物时应考虑到不同激素受体状态的组合。

Purpose To investigate the expression and significance of androgen receptor （AR） in breast carcinoma with different ER and PR status.Methods Immunohistochemical method was used to detect AR,ER and PR expression in 173 cases of breast carcinoma,and all the cases were grouped according to：（1） AR status：AR^-positive subgroup and AR^-negative subgroup,（2） ER status：En subgroup （negative for both ER and PR）,Ep subgroup （positive for ER and/or PR）,（3）AR,ER and PR status：En-AR^＋ subgroup （AR^-positive cases of En subgroup）,En-AR^-subgroup （AR^-negative cases of En subgroup）,Ep-AR^＋ subgroup （AR^-positive cases of Ep subgroup）,and Ep-AR^-subgroup （AR^-negative cases of Ep subgroup）.En-AR^-subgroup also was called negative-for-all subgroup,and the rest three subgroups were called partly-or-completely positive subgroup （positive for at least one of the three markers）,and then,the groups were compared with clinicopathological features.Results The positive rate of AR was 62.8% （54/86） in Ep subgroup and 37.9%（33/87） in En subgroup,and there was significant difference between them （P=0.001）.Compared to AR^-negative subgroup,AR^-positive subgroup had smaller tumor size,less mitosis count and lower grade（P0.05）.Compared to the other three subgroups,En-AR^-subgroup had more mitosis count and higher grade （P0.01）.In En subgroup,AR^-positive cases had less mitosis count and lower grade （P0.05）,and in Ep subgroup,AR^-positive cases had higher stage（P=0.000）,but no significant difference were found among partly or completely positive subgroups.Conclusions The expression of AR may play a different role in breast carcinoma with different ER and PR status,because it indicates good prognosis in negative for both ER and PR subgroup,but bad in ER and/or PR positive subgroup.When choosing a personalized therapy,all the combinations of hormone receptor status should be considered for the patients.