雄激素受体在早期Luminal型乳腺癌中的表达及其与预后的关系

Expression of androgen receptor in early Luminal breast cancer and its relationship with prognosis

目的探讨雄激素受体(AR)在早期Luminal型乳腺癌中的表达情况及其对预后的影响。方法选取2014年1月至2015年12月十堰市太和医院收治的早期Luminal型乳腺癌258例,采用免疫组化法检测乳腺癌组织AR的表达情况,分析AR表达与患者临床病理特征及预后的关系。结果258例早期Luminal型乳腺癌患者中AR阳性率为63.9%(165/258)。AR阳性患者与AR阴性患者年龄、月经状态、肿瘤直径、孕激素受体(PR)表达、人表皮生长因子受体2(HER-2)表达、Ki-67表达及分子分型比较差异均无统计学意义(均P>0.05),而淋巴结转移情况、组织学分级、TNM分期及雌激素受体表达等情况比较差异均有统计学意义(均P<0.05)。生存分析显示,AR阳性患者的无病生存期(DFS)及总生存期(OS)均优于AR阴性患者(均P<0.05)。进一步生存分析发现,Luminal B HER-2阴性型中AR阳性患者的DFS、OS均优于AR阴性患者(均P<0.05),而AR表达情况不影响Luminal A及Luminal B HER-2阳性型患者的预后(均P>0.05)。多因素分析显示,AR是早期Luminal型乳腺癌患者DFS的影响因素,AR阳性患者有较优的DFS。结论早期Luminal型乳腺癌中AR阳性患者具有临床分期早、肿瘤分化好、肿瘤侵袭性低及预后好的特点。AR或可成为早期Luminal型乳腺癌患者的预后指标及潜在治疗靶点。

Objective To investigate the expression of androgen receptor(AR)in early Luminal type breast cancer and its relationship with the prognosis of patients.Methods A total of 258 cases of Luminal type breast cancer admitted in Shiyan Taihe Hospital from January 2014 to December 2015 were enrolled.The expression of AR was tested by immunohistochemistry,and the relationship of AR expression with clinicopathological features and prognosis was analyzed.Results The positive rate of AR in early Luminal type breast cancer was 63.9%(165/258).There were significant differences between AR positive and AR negative patients in axillary lymph status,histological grade,TNM stage and ER expression(all P<0.05),while the differences in age,menstrual status,tumor size,progesterone receptor(PR)expression,human epidermal growth factor receptor 2(HER 2)expression,Ki 67 and molecular typing were not statistically significant(all P>0.05).Survival analysis showed that AR-positive patients had better overall survival(OS)and disease-free survival(DFS)than AR negative patients(all P<0.05).Further analysis revealed that AR-positive expression in Luminal B(HER 2 negative)had longer DFS and OS than AR-negative patients(all P<0.05),but AR status did not affect the prognosis of patients with Luminal A and Luminal B(HER-2 positive)(all P>0.05).Multivariate analysis showed that AR was an influential factor of DFS in patients with early Luminal type breast cancer,and AR-positive patients had better DFS.Conclusion AR positive patients in early Luminal type breast cancer are associated with early clinical stage,good tumor differentiation,weak invasiveness and good prognosis.AR may be a prognostic indicator and potential therapeutic target for patients with early Luminal type breast cancer.