雄激素受体、p53在三阴性乳腺癌中的表达及其意义

Expression of Androgen Receptor and p53 In the Prognosis of Three-Negative Breast Cancer

【目的】探讨雄激素受体（AR）、人体抑癌基因p53在三阴性乳腺癌（triple-negative breast cancer，TNBC）中的表达及其意义。【方法】收集2010年1月至2011年12月本院诊治的87例TNBC患者（三阴组）和231例非TNBC患者（非三阴组）的临床资料，采用免疫组化法检测两组AR、p53的表达，并分析其与临床病理特征和预后的关系。【结果】三阴组患者p53和AR的阳性表达率分别为49．43％（43／87）和37．93％（33／87），明显高于非三阴组的33．77％（78／231）和27．3％（63／231），其差异均有统计学意义（χ2=9．451，P=0．025；χ2=8．287，P=0．031）；AR阳性表达与淋巴结转移相关（P〈0．05）；p53阳性表达与组织学分级和分子类型相关（P〈0．05），而其他指标与p53、AR阳性表达均不相关（P〉0．05）；三阴组患者5年局部复发率和远处转移率显著高于非三阴组患者（P〈0．05），5年生存率显著低于非三阴组患者（P〈0．05）。【结论】TNBC中p53和AR的表达上调，与肿瘤细胞分化程度、淋巴结转移状态相关；p53和AR可作为乳腺癌患者预后的预测指标。

[Objective] To investigate the relationship between the expression of androgen receptor and p53 in the prognosis of three negative breast cancer. [Methods]From January 2010 to December 2011, the clinical data of 87 patients with TNBC （three negative group） and 231 patients without TNBC （non-three negative group） were collected. The expression of AR and pS3 was detected by immunohistoehemistry and its re- lationship with clinicopathological features and prognosis was analyzed .[Results]The positive rates of p53 and AR in the three negative group were 49.43 % （ 43/87 ） and 37.93 % （ 33/87 ） , respectively , which were significantly higher than those in the non-three negative group p 33.77 % （ 78/231 ） and 27.3 % （ 63/231 ） , the differences were statistically significant（2/.2 = 9.451, P = 0.025 ;χ2 = 8. 287, P = 0.031）. The positive ex- pression of AR was related to lymph node metastasis （ P 〈0.05）, the positive expression of p53 was related to histological grade and molecular type （ P 〈0.05）, there was no correlation between other markers and the positive expression of p53 and AR （ P 〉0.05）. The 5-year local recurrence rate and distant metastasis rate in the three negative group was significantly higher than those in the non-three negative group （ P 〈0.05）. The 5-year survival rate was significantly lower than that in non-three negative group （ P 〈0. 05）.[Conclusion] The expression of p53 and AR in TNBC was up-regulated, which was related to the differentiation of tumor cells and the status of lymph node metastasis, p53 and AR can be used as predictors of prognosis in patients with breast cancer .