不同分子分型乳腺癌患者中雄激素受体的表达与临床病理特征的关系

The Relationship between Androgen Receptor Expression and Clinicopathological Features in Breast Cancer Patients with Different Molecular Types

目的探讨不同分子分型乳腺癌患者中雄激素受体的表达与临床病理特征的关系。方法随机选取2020年1—12月于该院就诊的乳腺癌患者100例,借助免疫组织化学法(immunohistochemistry,IHC)对患者肿瘤组织进行检测,记录雄激素受体(androgen receptor,AR)表达情况,分析乳腺癌患者中AR的表达情况、临床病理参数与AR表达之间的关系。结果该研究100例患者中,AR阳性67例(67%),AR阴性33例(33%)。AR阳性表达患者中IHC染色结果多为细胞核呈现出黄褐色染着色,染色形状多为颗粒状,而AR阴性表达患者中细胞核无IHC染着色出现。在所有的病理参数中,淋巴结阴性(61.2%vs 24.2%,χ^(2)=12.081,P=0.001)、组织学分级低(Ⅰ/Ⅱ)(68.7%vs 30.3%,χ^(2)=13.200,P<0.001)的患者AR阳性表达的概率更高,而AR表达与年龄、病理类型、肿瘤大小等差异无统计学意义(P>0.05)。AR表达状况与蛋白质标记物孕激素受体(progesterone receptor,PR)、雌激素受体(estrogen receptor,ER)、Ki-67和人类表皮生长因子受体2(human epidermal growth factor receptor 2,HER2)表达状况之间存在明显的相关性。与AR阴性表达相比,在PR阳性(53.7%vs 30.3%,χ^(2)=4.886,P=0.027)、ER阳性(61.2%vs 36.4%,χ^(2)=5.472,P=0.019)、Ki-67<14%(73.1%vs 51.5%,χ^(2)=4.605,P=0.032)以及HER-2阳性(34.3%vs 12.1%,χ^(2)=5.532,P=0.019)中,AR阳性表达的概率更高。AR表达状况与乳腺癌分子分型存在相关性,AR阳性表达在HER-2过表达、Luminal-A、Luminal-B中概率较高,而在三阴性乳腺癌中阳性表达概率较低,乳腺癌的分子分型不同,AR表达状况间差异有统计学意义(P<0.05)。结论乳腺癌患者AR表达状况与病理参数、分子分型存在相关性,即在淋巴结阴性、组织学低分级中AR阳性表达率更高;在、Her-2过表达型乳腺癌中AR阳性率比三阴性乳腺癌阳性率更高。

Objective To investigate the relationship between androgen receptor expression and clinicopathological features in breast cancer patients with different molecular types.Methods 100 breast cancer patients who were treated in the hospital from January to December 2020 were randomly selected.The tumor tissues of the patients were detected by immunohistochemistry(IHC),and androgen receptor(AR)expression,and the relationship between AR expression,clinicopathological parameters and AR expression in breast cancer patients was analyzed.Results Among the 100 patients in this study,67 cases(67%)were AR positive and 33 cases(33%)were AR negative.The IHC staining results of AR-positive patients were mostly yellow-brown staining,and the staining shape was mostly granular,while AR-negative patients had no IHC staining.Among all pathological parameters,patients with negative lymph nodes(61.2%vs 24.2%,χ^(2)=12.081,P=0.001)and low histological grade(I/II)(68.7%vs 30.3%,χ^(2)=13.200,P<0.001)had a higher probability of AR positive expression,but there was no statistically significant difference in AR expression with age,pathological type,tumor size,etc.There were obvious correlations between AR expression status and protein markers PR(progesterone receptor,PR),ER(estrogen receptor,estrogen receptor,ER),Ki-67 and HER-2(human epidermal growth factor receptor 2,HER-2).Compared with AR negative expression,PR positive(53.7%vs 30.3%,χ^(2)=4.886,P=0.027),ER positive(61.2%vs 36.4%,χ^(2)=5.472,P=0.019),Ki-67<14%(73.1%vs 51.5%,χ^(2)=4.605,P=0.032)and HER-2 positive(34.3%vs 12.1%,χ^(2)=5.532,P=0.019),the probability of AR positive expression was higher.There was a correlation between AR expression status and molecular typing of breast cancer.AR positive expression has a higher probability in HER-2 overexpression,Luminal-A,and Luminal-B,but a lower probability of positive expression in triple-negative breast cancer.There were statistically significant differences in AR expression among different molecular types(P<0.05).Conclusion There is a correlation between AR expression status and pathological parameters and molecular typing in breast cancer patients,that is,AR positive expression rate is higher in lymph node negative and low histological grades.The positive rate of AR in Her-2 overexpressing breast cancer is higher than that in triple negative breast cancer.