雄激素受体在乳腺癌中的表达及其预后意义

Expression of androgen receptor in breast cancer and its prognostic significance

目的·探讨雄激素受体(AR)在乳腺癌中的表达情况及其预后意义。方法·选取2013年10月-2016年12月就诊于上海交通大学医学院附属瑞金医院、仁济医院及苏州九龙医院的183例女性乳腺癌患者,采用免疫组织化学检测肿瘤组织中AR蛋白的表达,分析AR表达与临床病理特征的相关性;采用在线生存分析数据库(Kmplot)观察AR基因的表达与乳腺癌患者预后的相关性。结果·AR蛋白的阳性率为47.5%。AR阳性者具有相对较低的组织学分级[57.6%(G1/G2)vs 25.0%(G3),P<0.05]。在雌激素受体、孕激素受体及P53阳性者中,AR蛋白的阳性率高于阴性组(P<0.05)。分子分型为管腔型者AR蛋白的阳性率高于表皮生长因子受体-2过表达及三阴性乳腺癌组(51.7%vs 31.6%,P<0.05)。单因素分析结果显示,AR基因阳性的乳腺癌患者的无复发生存、总生存、无远处转移生存明显高于AR阴性者(P<0.05)。结论·乳腺癌中AR阳性患者的预后较好,AR通路抑制剂可能成为治疗AR阳性乳腺癌的选择。

Objective·To investigate the expression of androgen receptor(AR)in human breast cancer and its prognostic significance.Methods·A total of183female patients with breast cancer were selected.The expression of AR in breast cancer tissues was detected by immunohistochemical staining.The relationship of AR expression with the clinicopathological characteristics was analyzed.Survival analysis of AR gene expression by an online database(Kmplot)was also performed.Results·The positive rate of AR expression was47.5%and was significantly higher in grade1and grade2group than that in grade3group(57.6%vs25.0%,P<0.05).Breast cancer patients with estrogen receptor,progesterone receptor and P53positive expression had significantly increased AR levels(P<0.05).AR expression were significantly higher in patients with luminal type as compared with those in patients with human epidermal growth factor receptor-2(HER2)positive and patients with triple negative breast cancer(51.7%vs31.6%,P<0.05).Kaplan-Meier curves identified that AR gene expression was positively correlated with relapse-free survival,overall survival and distant metastasis-free survival of breast cancer patients(P<0.05).Conclusion·The breast cancer patients with AR positive expression have a better prognosis,which suggests that inhibitors of AR pathway may be a treatment option for breast cancer.