雄激素受体在非特殊类型浸润性乳腺癌中的表达及预后意义的探讨

Prognostic Significance of Androgen Receptor Expression in Invasive Breast Carcinoma of Non-Specific Type

目的:通过免疫组化检测雄激素受体(androgen receptor,AR)在非特殊类型浸润性乳腺癌中的表达情况,分析AR与非特殊类型浸润性乳腺癌临床病理特征的关系,探讨AR与非特殊类型浸润性乳腺癌患者预后之间的关系,为临床医生判断预后提供参考。方法:收集2017年1月至2019年6月在本院经病理诊断为非特殊类型浸润性乳腺癌的病例279例,统计其临床资料,采用Envision两步法检测AR、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)以及细胞增殖标记抗原Ki-67的表达情况,分析AR与非特殊类型浸润性乳腺癌的不同组织学分级、分子分型及Ki-67之间的关系。结果:279例非特殊类型浸润性乳腺癌中组织学分级I级6例(2.15%),Ⅱ级217例(77.78%),M级44例(15.77%);分子分型Luminal A型46例(16.49%),Luminal B型153例(54.84%),HER2过表达型24例(8.60%),三阴性型37例(13.26%)。AR的总阳性率为64.87%(181/279),在组织学I级(83.33%)和U级(6.66%)中的阳性率比在Ⅲ级(45.45%)中高(P=0.008);AR在Luminal A型(71.74%)、Luminal B型(68.63%)和HER2过表达型(62.50%)中的阳性率高于三阴性型(27.02%)乳腺癌(P<0.001)0 ER阳性表达组的AR阳性率(73.71%)高于ER阴性表达组(44.71%),差异有统计学意义(P<0.001);PR阳性表达组(71.07%)高于PR阴性表达组(50.00%),差异有统计学意义(P=0.001)。Ki-67阴性表达组的非特殊类型浸润性乳腺癌中AR阳性率(79.45%)高于Ki-67阳性表达组(59.71%)(P=0.002)。结论:AR的表达状态可能是乳腺癌预后的指标之一,高表达者可能预后更好。

Objective:To explore the relationship between androgen receptor(AR)and clinicopathological features,and explore the relationship between AR and prognosis of patients with invasive breast carcinoma of non-specific type,so as to provide experience for clinically evaluating prognosis.Methods:Clinical data of 279 invasive breast carcinoma of non-specific type were selected between January 2017 to June 2019.Expressions of AR,estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor receptor-2(HER2)and Ki-67 were detected with the Enlision,a two-step method.And the relation of AR to histological grade,molecular typing and Ki-67 were analyzed.Results:There were 279 cases of invasive breast carcinoma of non-specific type,including6 cases in grade Ⅰ(2.15%),217 cases in grade Ⅱ(77.78%)and44 cases in grade Ⅲ(15.77%).46 cases were in Luminal A type(16.49%),153 cases in Luminal B type(54.84%),24 cases in HER2 overexpression type(8.60%)and 37 cases in triple-negative type(13.26%).The overall positive expression rate of AR was 64.87%(181/279).The positive rates of AR in grade I breast carcinoma(83.33%)and grade Ⅱ breast carceinoma(68.66%)were high-er than that in grade Ⅱ breast carcinoma(45.45%)(P=0.008).The positive rates of AR in Luminal A type(71.74%),Luminal B type(68.63%)and HER2 overexpression type(62.50%)than that in triple-negative type(27.02%)(P<0.001).The positive rate of AR in ER-positive breast carcinoma was significantly higher than that in ER-negative breast carcinoma(73.71%rs44.71%,P<0.001);it in PR-positive breast carcinoma was significantly higher than that in PR-negative breast carcinoma(71.07% vs 50.00%,P=0.001);and it in Ki-67-negative breast carcinoma was significantly higher than that in Ki 67-positive breast carcinoma(79.45%1s 59.71%,P=0.002).Conclusion:AR may be used as an indicator to predict the prognosis of breast carcinoma.Higher expression of AR indicates better prognosis.