乳腺癌雄激素受体的表达及其与临床病理指标和分子亚型的关系

Androgen receptor expression in breast cancer and its relationship with clinicopathological indicators and molecular subtypes

目的探讨雄激素受体(androgen receptor,AR)在乳腺癌组织中的表达及其与乳腺癌临床病理指标和分子亚型的关系。方法采用免疫组织化学方法检测200例乳腺癌患者肿瘤组织中雄激素受体、雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)、人表皮生长因子受体-2(human epidermal growth factor receptor-2,HER2)、细胞增殖核抗原(Ki-67)的表达情况,并结合患者年龄、月经状态、肿瘤大小、淋巴结转移情况、病理TNM(p TNM)分期及肿瘤组织学分级等临床病理指标进行分析。结果乳腺癌组织中AR阳性率为88.5%。ER阴性乳腺癌AR阳性率为67.9%,ER阳性乳腺癌AR阳性率为95.9%。PR阴性乳腺癌AR阳性率为68.4%,PR阳性乳腺癌AR阳性率为96.5%。AR表达与ER和PR呈正相关(P<0.01)。在肿瘤组织学Ⅰ级和Ⅱ级的乳腺癌中AR阳性率为94.9%,Ⅲ级AR阳性率为74.2%,组织学分级越低者AR的阳性表达率越高(P<0.01)。乳腺腔内A型(Luminal A型)乳腺癌AR阳性率为96.3%,乳腺腔内B型(Luminal B型)AR阳性率为96.0%,HER2阳性型AR阳性率为87.5%,三阴性乳腺癌(triple-negative breast cancer,TNBC)AR阳性率为44%,表明不同分子亚型AR表达率有差异(P<0.01)。4组不同病理分子分型两两比较,Luminal A型乳腺癌AR表达高于TNBC(P<0.01);Luminal B型乳腺癌AR表达高于TNBC(P<0.01);HER2阳性型乳腺癌AR表达高于TNBC(P<0.01)。Luminal A型、Luminal B型与HER2阳性型两两比较,AR表达无差异。结论 AR在乳腺癌组织中广泛表达。与TNBC相比,AR更多的表达在Luminal A型、Luminal B型与HER2阳性型乳腺癌组织中,但TNBC中AR的表达仍可达到44%,因此AR可以作为一个潜在的治疗靶点。

Objective To investigate androgen receptor（AR） expression in breast cancer tissues and its relationship with clinicopathological indicators and molecular subtypes.Methods Androgen receptor（AR）, estrogen receptor（ER）, progesterone receptor（PR）, human epidermal growth factor receptor-2（HER2） and proliferating cell nuclear antigen Ki-67 expression were evaluated in 200 breast cancer cases by immunohistochemistry assays.Data including patients＇ age, menstrual status, tumor size, lymph node metastasis, pathology TNM（pTNM） stage and tumor histological grade and other clinical pathological indicators were analyzed.Results The positive rate of AR in breast cancer tissue was 88.5%.It was 67.9% in ER negative breast cancer versus 95.9% in ER positive breast cancer, and 68.4% in PR negative breast cancer versus 96.5% in PR positive breast cancer.AR expression was positively associated with ER and PR expression（P〈0.01, respectively）.The positive rate of AR was 94.9% in gradeⅠand gradeⅡbreast cancer, and 74.2% in gradeⅢ.The lower the histological grade was, the higher the positive rate of AR expression was（P〈0.01）.The positive rate of AR was 96.3% in Luminal A subtypes and 96% in Luminal B subtypes, and was 87.5% in HER2 positive subtypes, and 44% in triple negative breast cancer（TNBC）, and there were significant differences in different molecular subtypes（P〈0.01）.Subtypes of Luminal A, Luminal B, and HER2 had higher AR expression rate when compared with TNBC（P〈0.01） with no significant difference between the former 3 subtypes.Conclusion AR is widely expressed in breast cancer tissues.Compared with the TNBC, AR expression is higher in Luminal A, Luminal B and HER2 positive breast cancers.However, it is 44% in TNBC subtype.AR could serve as a potential therapeutic target to breast cancer.