AR在ER阳性和阴性乳腺癌中的表达及临床意义

Expression of AR in ER-positive and ER-negative breast cancers and its clinicopathologic significance

目的探讨雄激素受体(androgen receptor,AR)在ER阳性和阴性乳腺癌中的表达及其与临床病理特征、预后的关系。方法收集270例浸润性乳腺癌患者的临床病理资料,将ER分成阳性组与阴性组。分析两组AR表达与乳腺癌临床病理特征及多种蛋白标志物的关系,并复习相关文献。使用Kaplan-Meier Plotter数据库对AR在乳腺癌患者的预后价值进行分析。结果270例浸润性乳腺癌患者AR阳性率为78.5%。AR与ER、PR、HER-2、CK5/6、组织学分级、Ki-67增殖指数、神经侵犯及脉管侵犯有关(P<0.05)。ER阳性组中AR阳性率(88.1%)高于ER阴性组(60.2%)。进一步分析发现ER阳性组中AR与组织学分级及CK5/6阳性有关(P<0.05);ER阴性组中AR与HER-2、CK5/6、组织学分级、神经侵犯、脉管侵犯、淋巴结转移及pTNM分期有关(P<0.05)。Kaplan-Meier Plotter预后分析发现,ER阳性组中AR高表达者总生存期显著高于低表达者,而ER阴性组中AR高表达者总生存期低于低表达者(P<0.05)。结论AR在ER阳性和阴性乳腺癌患者中的阳性率及临床意义不同,检测AR表达可为不同ER表达状态患者预后提供参考。

Purpose To investigate the expression of AR in ER positive and negative breast cancer(BC)patients and its relationship with multiple pathological parameters,related protein markers and prognosis,with review of the relevant literature.Methods Clinicopathological data of 270 cases of invasive BC patients were collected.According to the differences of ER expression level,they were divided into two groups:ER-positive group and ER-negative group.The clinicopathological features,related protein markers of the two groups were compared.Kaplan-Meier Plotter online database was used to analyze the prognosis of patients of BC.Results The positive rate of AR in 270 BC patients was 78.5%.AR was related to the ER and PR expression status,HER-2 expression,Ki-67 proliferation index,CK5/6 expression,histological grade,nerve invasion and vascular invasion(P<0.05).In addition,the proportion of AR positive expression in ER-positive group(88.1%)was higher than that in ER-negative group(60.2%).In addition,AR was related to histological grade and CK5/6 expression in ER-positive group(P<0.05).AR was related to histological grade,HER-2 expression,CK5/6 expression,nerve invasion,vascular invasion and lymph node metastasis and pTNM staging in ER-negative group(P<0.05).Kaplan-Meier Plotter database showed that the overall survival(OS)of BC patients with high AR expression in the ER-positive group was significantly higher than that in patients with low AR expression,while the OS of BC patients with high AR expression in the ER-negative group was lower than that of patients with low AR expression(P<0.05).Conclusion The positive expression rate and clinicopathological significance of AR in ER-positive and ER-negative BC patients are different.The detection of AR expression status could provide the basis for predicting the prognosis of BC patients with different ER status.