AR在不同ER状态乳腺癌中的表达及临床病理意义

Expression and Clinicopathologic Significance of AR in Breast Cancer with Different ER Status

  • 摘要:
      目的  探讨雄激素受体(AR)在不同雌激素受体(ER)状态乳腺癌中的表达与临床病理特征间的关系及预后。
      方法  从乳腺浸润性导管癌ER阳性和阴性病例中分别随机选取111例(ER+组)与113例(ER-组),共计224例。采用免疫组化方法检测AR、ER、PR、HER-2、Ki-67、P53表达,对不同ER状态乳腺癌中AR表达与临床病理资料及预后因素进行分析。
      结果  AR在浸润性导管癌中的阳性表达率为67.9%(152/224),ER+组和ER-组分别为80.2%(89/111)、55.8%(63/113)。ER+组中AR的表达与肿瘤大小、组织学分级、pTNM分期和有无淋巴结转移相关(P < 0.05);在ER-组中AR的表达与组织学分级、HER-2表达、绝经状态相关(P < 0.05)。单因素生存分析显示在ER+组和ER-组AR阳性者均具有较好的预后(P < 0.001,P=0.046),Cox多因素回归分析显示在ER+组AR表达可作为影响无瘤生存的独立因素。
      结论  AR可以作为指导临床内分泌治疗新的靶标,为不同ER状态乳腺癌激素治疗提供依据。

     

    Abstract:
      Objective  To investigate the correlation between the expression of androgen receptor (AR) and the clinicopathologic characteristics and prognosis of the breast invasive ductal carcinoma (IDC) of various estrogen receptor (ER) statuses.
      Methods  From January to December 2004, 111 cases from ER+ cases and 113 cases from ER- cases were randomly allocated into two IDC groups: ER+ group and ER- group. The protein expression of AR, ER, PR, HER-2, Ki-67, and P53 from the 224 IDC cases were assayed using immunohistochemistry. The current study focused on the assessment of protein expressions in the groups (ER+/AR+, ER+/ AR-, ER-/AR+, and ER-/AR-) and their main characteristics. The prognostic differences in the cases of different AR and ER status were also evaluated.
      Results  The positive rate of AR was 67.9% (152/224), and the rate of AR expression was 80.2% (89/111) and 55.8% (63/113) in the ER-positive and ER-negative cases, respectively. The AR expression in the ER-positive tumors was associated with tumor size, histological grade, pTNM, and endocrine therapy (P < 0.05). The AR expression in the ER-negative tumors was associated with the histological grade of the tumor, HER2 over-expression, and postmenopausal status (P < 0.05). The univariate analysis showed that the patients with AR-positive tumors in the ER+ and ER- groups had significantly better disease-free survival than those with AR-negative tumors (P < 0.001, P=0.046). The Cox regression analysis revealed that AR expression is an independent prognostic factor in the ER+ group.
      Conclusion  AR is expressed in a great number of breast cancers of various ER status and it shows significant correlation with clinical hormone therapy and pathologic prognostic factors. Especially, AR plays a potential role in the clinical management of women patients with ER-negative breast cancer.

     

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