AhR在乳腺癌组织中的表达及其与预后相关性的研究

Expression of aryl hydrocarbon receptor and its prognosis in primary breast cancer patients

目的探讨芳香烃受体(AhR)在原发性乳腺癌组织中的表达情况及其与预后的关系。方法收集64例原发性乳腺癌患者的临床病理资料并随访,中位随访时间70.4个月。采用免疫组化EliVision法检测乳腺癌组织中AhR、C-erbB2及p53的表达情况,分析AhR与年龄、淋巴结转移数目、雌激素受体(ER)、孕激素受体(PR)、C-erbB2、p53等因子以及预后的关系。结果 64例原发性乳腺癌AhR的阳性表达率为26.6%(17/64)。AhR表达与C-erbB2表达呈正相关(P=0.017),经ER分层后,仅ER阴性患者上述两者有相关性(P=0.006)。单因素分析表明,AhR阳性表达乳腺癌患者的无病生存时间(DFS)较短(P=0.026);多因素分析表明,AhR是乳腺癌患者预测DFS的独立因素(P=0.049),也是影响总生存时间(OS)的危险因素(HR=2.448P=0.08)。经分层分析,ER阴性乳腺癌患者中AhR阳性表达者预后更差。结论 AhR是预测原发性乳腺癌患者预后的独立因素,尤其在ER阴性乳腺癌中,AhR阳性表达提示患者预后差。

Objective To investigate the expression of AhR and evaluate its prognostic significance in primary breast cancer patients.Methods Sixty-four cases of primary breast cancer patient were followed up.The media follow-up time was 70.4 months.AhR,C-erbB2,p53 status were determined by immunohistochemical testing.The relationship between AhR and other clinical and pathological indicators（ER,PR,C-erbB2,p53,ages and lymph nodes） and prognosis were analyzed.Results Positive expression rate of AhR was 26.6%（17/64） in 64 primary breast cancer cases.Expression of AhR was positively correlated with the C-erbB2 expression status（P=0.017）,especially in ER-negative cases（P=0.006）.In single factor analysis,AhR expression indicated the poor disease-free survival（DFS） significantly（P=0.026）.A Cox regression multivariate analysis also demonstrated that AhR was an independent prognostic factor of DFS（P=0.049） and a risk factor of OS（HR=2.448,P=0.08）.In ER-negative cases,AhR was the poor prognostic factor for DFS（χ2=5.516,P=0.019） and OS（χ2=4.153,P=0.042）.Conclusion AhR expression is an independent prognostic factor for short DFS in primary breast cancer patients,especially in ER-negative cases.