BRCA1、AR及Ki-67在三阴性乳腺癌中的表达及临床病理意义

Expression of BRCA1,AR and Ki-67 in Triple-Negative Breast Cancer and Its Clinicopathological Significance

目的探讨三阴性乳腺癌中乳腺癌易感基因1(BRCA1)、雄激素受体(AR)与Ki67的表达关系及其临床病理特征。方法收集经手术切除或穿刺活检的三阴性乳腺癌(TNBC)病例94例,应用免疫组化SP法,测定BRCA1、AR及Ki67的表达情况,分析三者在TNBC中表达的相关性及其与相关临床资料的关系。结果BRCA1、AR及Ki67高增殖表达在三阴性乳腺癌中的阳性率分别为57.4%(54/94)、35.1%(33/94)及89.4%(84/94),BRCA1阴性表达与Ki67高增殖表达(Ki67≥20%)显著相关(P<0.05);AR阴性表达与Ki67高增殖表达(Ki67≥20%)显著相关(P<0.05);BRCA1与AR表达不相关(P>0.05.);BRCA1蛋白、AR蛋白及Ki-67蛋白表达均与年龄无关,与发生肿块的部位(左侧或右侧乳腺)无关(P均>0.1);结论三阴性乳腺癌中,AR阳性、BRCA1阳性的病例对应的Ki67增殖指数更低,提示AR+BRCA1+的三阴性乳腺癌可能对应更好的临床预后;联合检测AR及BRCA1或许可以成为三阴性乳腺癌新的预后指标和治疗靶点。

Objective To investigate the relationship between the expression of breast cancer susceptibility gene 1(BRCA1),androgen receptor(AR)and Ki67 as well as its clinicopathological characteristics in triple-negative breast cancer.Methods 94 patients with triple-negative breast cancer(TNBC)who underwent surgical resection or needle biopsy were collected.The expression levels of BRCA1,AR and Ki67 were detected by SP immunohistochemical method,which analyze the correlation of the expression levels of BRCA1,AR and Ki-67 in TNBC and the correlation with relevant clinical data.Results The positive rates of high proliferative expression of BRCA1,AR and Ki67 in triple-negative breast cancer were 57.4%(54/94),35.1%(33/94)and 89.4%(84/94),respectively.Negative expression of BRCA1 was significantly correlated with high proliferative expression of Ki67(Ki67≥20%)(P<0.05).AR negative expression was significantly correlated with Ki67 hyperproliferative expression(Ki67≥20%)(P<0.05).There was no correlation between BRCA1 and AR expression(P>0.05).The expression of BRCA1 protein,AR protein and Ki-67 protein were independent of age and tumor site(left or right breast)(all P>0.1).Conclusion In triple-negative breast cancer,the cases with AR positive and BRCA1 positive have lower Ki67 proliferation index,suggesting that AR+BRCA1+triple-negative breast cancer may be associated with better clinical prognosis.Combined detection of AR and BRCA1 may be a new prognostic index and therapeutic target for triple-negative breast cancer.