三阴性乳癌组织AR和Ki-67表达及临床意义

EXPRESSIONS OF AR AND Ki-67 AND THEIR CLINICAL SIGNIFICANCE IN TRIPLE NEGATIVE BREAST CANCER

目的探讨雄激素受体（AR）、增殖细胞核抗原（Ki-67）在三阴性乳癌（TNBC）组织表达及其临床意义。方法收集我院行保乳根治术或改良根治术乳癌病人的肿瘤组织切片120例，其中TNBC者60例，非三阴性乳癌（NTNBc）60例。应用免疫组化方法检测乳癌组织中AR、Ki67的表达，分析二者与TNBC病人年龄、体质量指数（BMI）、绝经状态、肿瘤大小、组织学分级及淋巴结转移的关系。结果AR在TNBC中的阳性表达率为26．67％（16／60），在NTNBC中的阳性表达率为80．00%（48／60），二者差异有统计学意义（x2=34．286，P〈0．01）。Ki67在TNBC中的阳性表达率为71．67％（43／60），在NTNBC中的阳性表达率为26．67％（16／60），二者差异有统计学意义（x2=24．307，P〈0．01）。TNBC病人AR表达与BMI、淋巴结转移及绝经状态有关（X2=4．972～10．774，P＜0．05），Ki67表达与淋巴结转移及组织学分级有关（x2=4．213、9．492，P〈0．05）。TNBC病人AR与Ki-67表达呈正相关（r=0．246，Pd0．05）。结论AR、Ki-67在TNBC中的表达与NTNBC相比有明显差异，有望成为新的预后指标，从而为预测TNBC的特点及内分泌治疗提供新的方向。

Objective To analyze the expressions of androgen receptor （AR） and nuclear associated antigen Ki-67 （Ki- 67） and their clinical significance in triple negative breast cancer （TNBC）. Methods The expressions of AR and Ki-67 in 60 ca- ses of TNBC and 60 of non TNBC were detected by immunohistochemistry. The correlation of the two expressions with patient＇s age, body mass index （BMI）, tumor size, menopausal state, lymphatic metastasis and histological staging was analyzed. Results The positive rate of AR expression in TNBC was 26.67% （16/60）, and that in non-TNBC was 80.00% （48/60）,the difference be- ing statistically significant （Z2=34.286,P〈0.01）. The positive rate of Ki-67 expression in TNBC was 71.67% （43/60）, and that in non-TNBC was 26.67% （16/60） （x2=24.307 ,P%0.01）. In TNBC, the expression of AR was associated with BM1, lymph node metastasis and menopausal state （Zz=4.972 10.774,P〈0.05）, and that of Ki 67 was related with lymph node metastasis and histological staging （x 2 = 4.213,9.492;P 〈0.05 ）, the expression of AR was positively correlated with that of Ki-67 （r= 0. 246, P 〈 0.05）. Conclusion The expressions of AR and Ki-67 in triple negative breast cancer-dramatically different as compared with non triple negative one are expected to become prognostic indicators and, thereby, provide a new direction for predicting the characte- ristics and endocrine therapy of this malignancy.