雄激素受体在雌激素受体阳性乳腺癌患者中的表达及其临床意义

Expression and significance of androgen receptor in estrogen receptor-positive breast cancer

摘要:

目的 探讨雄激素受体（AR）在雌激素受体（ER）阳性乳腺癌患者中的表达及与临床病理特征和预后的关系。方法 选取2012年10月—2013年8月锦州医科大学附属第一医院收治的ER阳性乳腺癌患者108例，采用免疫组织化学法检测AR表达水平。分析AR与患者临床病理特征及预后的关系。结果 108例ER阳性乳腺癌患者中，有72例（66.7%）AR阳性。AR阳性患者与AR阴性患者的T分期、组织学分级、PR表达比较，差异有统计学意义（P <0.05）。AR阳性的ER阳性患者总生存期（OS）和无病生存期（DFS）长于AR阴性的ER阳性患者（P <0.05）。多因素分析结果显示，AR是影响ER阳性乳腺癌患者OS［R=0.440（95% CI：0.206，0.937）］和DFS［R=0.359（95% CI：0.135，0.949）］的影响因素。结论 一定数量的ER阳性乳腺癌患者AR呈阳性，AR可以作为ER阳性乳腺癌患者的预后指标或治疗靶点。

Abstract:

Objective To investigate the expression of androgen receptor (AR) in estrogen receptor (ER)-positive breast cancer and its relationship with clinicopathological features and prognosis.Methods The AR expression of 108 patients with ER-positive breast cancer in the First Affiliated Hospital of Jinzhou Medical University from October 2012 to August 2013 was investigated by immunohistochemical staining. The relationship of AR expression with clinicopathological characteristics and clinical outcomes was analyzed.Results The positive rate of AR in 108 ER-positive breast cancer patients was 66.7% (72/108). AR-positive and AR-negative patients exhibited differences in T stage, histological grade, and progesterone receptor (PR) expression (P < 0.05). The overall survival (OS) and disease-free survival (DFS) of AR-positive patients were greater than those of AR-negative patients (P < 0.05). Multivariate analysis showed that AR expression was a prognostic factor for OS [R = 0.440 (95% CI: 0.206, 0.937)] and DFS [R = 0.359 (95% CI: 0.135, 0.949)] of patients with ER-positive breast cancer.Conclusions A part of ER-positive breast cancer patients are AR-positive, and AR can serve as a prognostic factor and therapeutic target for ER-positive breast cancer patients.