雄激素受体在乳腺癌新辅助治疗中的表达意义

Expression significance of androgen receptor in neoadjuvant therapy for breast cancer

目的研究雄激素受体(AR)在接受新辅助治疗(NAT)的乳腺癌中的表达情况,与临床特征及病理特征的相关性,以及影响病理完全缓解(pCR)的相关因素分析,为乳腺癌新辅助治疗提供个体化的治疗依据。方法收集孝感市中心医院2017年1月1日至2021年12月31日新辅助治疗的乳腺癌患者121例。采用χ^(2)检验(或必要时Fisher确切概率法),比较AR的表达与临床病理特征之间的关系,以及比较AR的表达与新辅助治疗后临床病理特征的关系,用Logistic回归分析各个变量与pCR的相关性。结果121例乳腺癌活检标本AR阳性率为70.2%。AR的表达与患者年龄、肿瘤大小、脉管侵犯、淋巴结状态、临床分期无相关性(P>0.05)。AR的表达与雌激素受体(ER)、人类表皮生长因子受体2(Her-2)、病理完全缓解(pCR)、MP分级、分子分型有相关性(P<0.05);AR的表达与孕激素受体(PR)、细胞增殖核抗原(Ki-67)、组织学分级无相关性(P>0.05)。不同分子分型乳腺癌新辅助治疗后,三阴性乳腺癌中AR的表达与pCR及MP分级有相关性(P<0.05)。多因素分析,AR可作为pCR的独立预测因素。结论AR可作为乳腺癌新辅助治疗是否能达到pCR的一种独立预测因素。

【Objective】To investigate the expression of androgen receptor in breast cancer receiving neoadjuvant therapy,its correlation with clinical and pathological features,and the related factors affecting pathological complete response,so as to provide individualized treatment basis for neoadjuvant therapy of breast cancer.【Methods】A total of 121 breast cancer patients who received neoadjuvant therapy in Xiaogan Central Hospital from January 1,2017 to December 31,2021 were collected.χ^(2) test(or Fisher's exact test if necessary)was used to compare the relationship between AR expression and clinicopathological features,as well as the relationship between AR expression and clinicopathological features after neoadjuvant therapy.Logistic regression was used to analyze the correlation between each variable and pCR.【Results】The positive rate of AR in 121 breast cancer biopsy specimens was 70.2%.The expression of AR was not correlated with age,tumor size,vascular invasion,lymph node status and clinical stage(P>0.05).The expression of AR was correlated with ER,HER-2,pCR,MP grade and molecular typing(P<0.05).The expression of AR was not correlated with PR,Ki67 and histological grade(P>0.05).After neoadjuvant therapy for different molecular subtypes of breast cancer,the expression of AR in triple-negative breast cancer was correlated with pCR and MP grade(P<0.05).Multivariate analysis showed that AR was an independent predictor of pCR.【Conclusion】AR can be used as an independent predictor of pCR in neoadjuvant therapy for breast cancer.