糖皮质激素受体在乳腺癌中的表达及临床意义

Expression of glucocorticoid receptor in breast cancer and its clinical significance

目的探讨乳腺癌组织中糖皮质激素受体(GR)的表达及临床意义。方法选取2021年7月至2023年6月于中国人民解放军联勤保障部队第九六〇医院行手术治疗的140例女性乳腺癌石蜡标本,采用免疫组化方法检测乳腺癌组织及癌旁组织中GR的表达,并应用χ^(2)检验、Fisher精确概率法以及Kruskal-Wallis秩和检验分析其与临床病理特征以及不同分子分型的关系。结果乳腺癌组织中GR蛋白阳性率高于癌旁组织阳性率(P<0.05)。组织学Ⅰ级GR阳性率高于Ⅱ级和Ⅲ级,GR阳性率与组织学分级呈负相关。TNM分期Ⅲ期GR阳性率高于Ⅱ期和Ⅰ期,GR阳性率与TNM分期呈正相关。发生淋巴结转移患者GR阳性率高于未发生转移患者。肿瘤直径>2 cm患者GR阳性率高于肿瘤直径≤2 cm患者,差异均有统计学意义(P<0.05)。ER阳性肿瘤GR阳性率高于ER阴性肿瘤,人表皮生长因子受体-2(HER-2)阴性肿瘤GR阳性率高于HER-2阳性肿瘤。GR表达在乳腺癌不同分子分型中存在明显差异,Luminal A型GR阳性率最高,其次是Luminal B型和三阴性乳腺癌(TNBC),少见于Her-2过表达型,差异有统计学意义(P<0.05)。患者年龄、月经、PR和Ki-67与GR表达均无明显相关性(P>0.05)。结论GR在乳腺癌组织中高表达,并与多种临床病理特征存在相关性,提示GR可能是一个潜在的乳腺癌进展预判指标和治疗的新靶点。

Objective To investigate the expression and clinical significance of glucocorticoid receptor(GR)in breast cancer tissues.Methods Paraffin specimens of 140 female breast cancer patients who underwent surgical treatment at the 960th Hospital of PLA Joint Logistics Support Force from July 2021 to June 2023 were selected.The expression of GR in cancer tissues and paracancer tissues was detected by immunohistochemistry,and its relationship with clinicopathological features and different molecular typing was analyzed byχ^(2) test,Fisher′s exact probability method,and Kruskal-Wallis′rank sum test.Results The rate of GR protein positivity in breast cancer tissues washigher than that in paracancer tissues(P<0.05).The rate of GR positivity was higher in histologic grade I than in gradesⅡandⅢ,and the rate of GR positivity was negatively correlated with histologic grade.The rate of GR positivity was higher in TNM stageⅢthan in stagesⅡandⅠand the rate of GR positivity was positively correlated with the TNM stage.The positive rate of GR in patients with lymph node metastasis was higher than that in patients without metastasis.The positive rate of GR in patients with tumor diameter>2cm was higher than that in patients with tumor diameter≤2 cm,and the differences were statistically significant(P<0.05).The GR positive rate was higher in ER-positive tumors than in ER-negative tumors,and the GR positive rate was higher in HER-2 negative tumors than in HER-2 positive tumors.There were significant differences in GR expression among different molecular phenotypes of breast cancer,with the highest rate of GR positivity in Luminal A,followed by Luminal B and TNBC,and less frequently in Her-2 overexpression phenotype,with statistically significant differences(P<0.05).There was no significant correlation between patients′age,menstruation,PR and Ki-67 and GR expression(P>0.05).Conclusion GR is highly expressed in breast cancer tissues and correlates with a variety of clinicopathologic features,suggesting that GR may be a potential prognostic indicator of breast cancer progression and a new target for treatment.