乳癌组织雄激素受体表达及其对预后的预测价值

EXPRESSION OF ANDROGEN RECEPTOR IN BREAST CANCER TISSUE AND ITS VALUE IN PREDICTING PROGNOSIS

目的分析乳癌组织中雄激素受体(AR)的表达与病理特征的关系,探讨AR对乳癌预后的预测价值。方法收集接受手术的144例乳癌病人的临床病理资料,评估AR阳性表达与各参数之间的关系,并用Log-rank检验和Kaplan-Meier生存分析方法分析其对无病生存期(DFS)和总生存期(OS)的影响。结果144例乳癌病人中AR阳性85例(占59.0%),临床分期Ⅲ期病人较Ⅰ~Ⅱ期病人AR阳性率低(χ^(2)=5.479,P<0.05),雌激素受体(ER)阳性病人较阴性病人AR阳性率高(χ^(2)=12.398,P<0.01)。生存分析结果显示,AR阳性病人DFS和OS明显优于AR阴性病人(χ^(2)=8.345、10.154,P<0.01)。Cox多因素回归分析显示,肿瘤直径、淋巴结浸润、ER阳性、Ki-67表达是病人DFS的独立预测因素(Wald=5.891~14.817,HR=1.517~2.494,P<0.05),年龄、淋巴结浸润、肿瘤直径、ER表达及Ki-67表达是OS的独立预测因素(Wald=6.130~14.547,HR=1.616~2.255,P<0.05)。结论乳癌组织中AR高表达,但其不是乳癌病人预后的独立预测因子。

Objective To investigate the association of androgen receptor(AR)expression in breast cancer tissue with clinicopathological features and the value of AR in predicting the prognosis of breast cancer.Methods Clinicopathological data were collected from 144 breast cancer patients who underwent surgery to analyze the association between AR expression and va-rious clinicopathological features,and the Log-rank test and the Kaplan-Meier survival analysis were used to investigate the in-fluence of AR expression on disease-free survival(DFS)and overall survival(OS).Results Among the 144 patients,85(59.0%)were positive for AR.StageⅢpatients had a significantly lower AR positive rate than stageⅠ-Ⅱpatients(χ^(2)=5.479,P<0.05),and the estrogen receptor(ER)-positive patients had a significantly higher AR positive rate than ER-negative patients(χ^(2)=12.398,P<0.01).The survival analysis showed that the AR-positive patients had significantly better DFS and OS than the AR-negative patients(χ^(2)=8.345,10.154;P<0.01).The multivariate Cox regression analysis showed that tumor diameter,lymph node invasion,ER positivity,and Ki-67 expression were independent predictive factors for DFS(Wald=5.891-14.817,HR=1.517-2.494,P<0.05),and age,lymph node invasion,ER expression,and Ki-67 expression were independent predictive factors for OS(Wald=6.130-14.547,HR=1.616-2.255,P<0.05).Conclusion AR is highly expressed in breast cancer tissue,but it is not an independent predictive factor for the prognosis of breast cancer patients.