雄激素受体在乳腺癌组织中的表达及其临床意义

Expression and clinicopathologic significance of androgen recepto in breast cancer

目的：探讨雄激素受体（ AR）在雌激素受体阴性（ ER－）及阳性（ ER＋）乳腺癌中的表达意义及其与临床病理指标之间的关系。方法从乳腺浸润性导管癌患者中随机抽取ER＋患者94例，ER?患者74例，共计168例。免疫组化检测AR、ER、PR、Her?2、Ki67的表达，分析AR在不同ER状态乳腺癌及乳腺癌分子亚型中表达情况及与临床病理指标的关系。结果 AR在乳腺浸润性导管癌中的阳性表达率为70．2％（118／168），在ER＋组及ER－组中分别为84．0％（79／94）、52．7％（39／74）。在不同分子分型中的表达分别为：Luminal A 8／10、Luminal B 84．5％（71／84），Her?2过表达型77．1％（27／35），三阴乳腺癌30．8％（12／39）。 ER＋组中，AR的表达与年龄（P＝0．008）相关；在ER－组中，AR的表达与年龄（P＝0．019）、绝经状态（ P＝0．010）、有无淋巴结转移（ P＝0．040）、Her?2（χ2＝15．914，P＜0．001）相关。结论AR在乳腺癌中广泛表达，并且在ER阴性乳腺癌中与良好的临床病理指标相关。 AR可以考虑作为ER阴性乳腺癌内分泌治疗的靶点，并且预测预后。

Objective To investigate the meaning of androgen receptor( AR) expression estrogen re?ceptor negative( ER-) and positive( ER+) breast cancer and the correlation between AR and clinicopathologic factors. Methods Ninety?four cases with ER+and 74 cases with ER-patients were randomly allocated into two groups from patients with invasive ductal carcinoma(IDC). The protein expression of AR,ER,PR,Her?2 and Ki?67 were assayed by immunohistochemistry. The expression of AR in breast cancer and breast cancer molecular subtypes in different ER states and the correlation with clinicopathologic characteristics were analyzed. Results The positive rate of AR in IDC was 70. 2%( 118/168) ,in the ER+ group and ER- group were 84. 0%( 79/94) and 52. 7%( 39/74 ) , respectively. The expression in different molecular subtypes were 80%( 8/10 ) , 84. 5%( 71/84) ,77. 1%( 27/35) ,30. 8%( 12/39) in Luminal A,Luminal B,Her?2 over expression and triple negative breast cancer,respectively. The AR epression in the ER+ tumors was related with age( P=0. 008);The AR ex?pression in the ER-tumors was related with age( P=0. 019) ,menstruate status( P=0. 010) ,axillary node status (P=0. 040),Her?2 over?expression(χ2=15. 914,P<0. 001). Conclusion AR is widely expressed in breast cancer,and is associated with good clinicopathologic parameters in ER negative breast cancer. AR is a good clini?copathologic factor and it plays a potential role in the clinical management of patients in ER- breast cancer. AR can be considered as a target for endocrine therapy in ER negative breast cancer,and predict the prognosis.