三阴性乳腺癌组织雄激素受体表达与超声特征及预后关系

The relationships between the expression of androgen receptor in triple-negative breast cancer tissues and the characteristics of ultrasound, and between that and prognosis

目的:探讨三阴性乳腺癌(TNBC)组织雄激素受体(AR)表达与超声特征及预后的关系。方法:选取医院收治的91例女性TNBC患者,采用免疫组化法检测肿瘤组织AR蛋白水平,根据检测结果将其分为AR阳性组(32例)和AR阴性组(59例)。所有患者均行超声检查,分析患者不同AR表达与超声特征及预后的关系。结果:91例TNBC患者中,AR阳性表达患者32例,阳性率为35.16%。AR阳性组及AR阴性组患者组织学分级和病理类型比较差异有统计学意义(χ^(2)=9.531,χ^(2)=7.675;P<0.05)。乳腺超声检查显示,AR阳性组患者肿块形态多呈不规则状,AR阴性组患者多呈圆形或椭圆形,组间肿块形态比较差异具有统计学意义(χ^(2)=17.268,P<0.05);AR阳性患者肿块边界多呈模糊或星芒状,边界不清晰,AR阴性组患者可见清晰边界,组间肿块边界比较差异具有统计学意义(χ^(2)=0.803,P<0.05)。AR阳性组患者3年生存率、无病生存期(DFS)与AR阴性组患者比较差异无统计学意义;AR阳性患者总生存期(OS)大于AR阴性患者(t=4.329,P<0.05)。结论:TNBC因AR表达不同而具有不同超声特征,借助TNBC超声特征差异可帮助临床医师更准确评估TNBC分型;AR表达阳性TNBC患者预后相对较好,因而AR可能成为TNBC潜在治疗靶点。

Objective: To explore the relationships between the expression of androgen receptor(AR) in triplenegative breast cancer(TNBC) tissue and the characteristics of ultrasound, and between that and prognosis. Methods:A total of 91 TNBC patients admitted to the hospital were selected. The immunohistochemical method was adopted to detect the level of AR protein of all patients, and all of them were divided into positive AR group(32 cases) and negative AR group(59 cases) according to the detection results. All of patients underwent ultrasound examination,and the relationships between the different AR expressions of patients and characteristics of ultrasound, and between that and prognosis. Results: In 91 TNBC patients, 32 cases were AR positive expression, and the positive rate was 35.16%. The differences of histological grade and pathological type between positive AR group and negative AR group were significant(x~2=9.531, x~2=7.675, P<0.05), respectively. The results of breast ultrasound examination showed that the most of the form of the lump of positive AR group appeared anomaly shape, and that of negative AR group appeared round shape or oval shape, the difference of that between two groups was significant(x~2=17.268, P<0.05).The boundaries of AR-positive patients were mostly fuzzy or asterism-shaped, and there was no clear boundary, and the clear boundary could be found in AR-negative patients, and the difference of that was significant(x~2=0.803,PFisher<0.05). There were no significant differences in three-year survival rate and disease-free survival(DFS) between AR-positive patients and AR-negative patients(P>0.05). The overall survival(OS) of AR-positive patients was significantly larger than that of AR-negative patients(t=4.329, P<0.05). Conclusion: TNBC has different ultrasound characteristics due to the difference of AR expression. The difference in ultrasound characteristics of TNBC can help clinicians more accurately assess the TNBC classification. AR-positive patients with TNBC have a relatively favorable prognosis, so AR might become a potential therapeutic target for TNBC.