雄激素受体在乳腺癌中的表达及其与雌、孕激素受体和HER2的关系

目的 研究雄激素受体(AR)在乳腺浸润性导管癌中的表达及其与雌激素受体(ER)、孕激素受体(PR)和HER2状态的关系,探讨其作为乳腺癌治疗靶点的可行性.方法 采用免疫组织化学EnVision法检测AR、ER、PR、HER2在175例乳腺浸润性导管癌中的表达,依据结果分为腺腔A型、腺腔B型、HER2过表达型和三阴性型(ER-/PR-/HER2-)组.结果 175例中AR阳性88例(50.3%),AR表达与ER、PR、HER2均呈正相关(P＜0.01).腺腔A型53例(30.3%),腺腔B型33例(18.9%),HER2过表达型23例(13.1%),三阴性型66例(37.7%),AR阳性率分别为56.6%(30/53),75.8%(25/33)、47.8%(11/23)和33.3%(22/66),组间AR阳性率差异显著(x2=17.054,P=0.001).三阴性型组AR阳性者核分裂象较少(x2=5.140,P=0.023),腺腔A型组AR阳性者多为年轻患者(x2=4.567,P=0.033),差异有统计学意义.其他组内AR表达与否和临床病理学特征比较无统计学意义.结论 AR在乳腺癌中有较高的阳性率,可作为乳腺癌,特别是三阴性型乳腺癌的治疗靶点.

Expression of androgen receptor in breast carcinoma and its relationship with estrogen receptor, progesterone receptor and HER2 status

Objective To investigate the expression of androgen receptor (AR) in breast carcinoma and its relationship with estrogen receptor (ER), progesterone receptor (PR) and HER2 status, and to discuss its potential as treatment target. Methods Immunohistochemical method was used to detect AR, ER, PR and HER2 expression in 175 cases of invasive ductal carcinoma of breast, which were divided into four groups: luminal A, luminal B, HER2- overexpression and triple negative group. Results Eighty-eight cases (50.3%) were AR positive in 175 cases, the expression of AR was positively correlated with ER, PR and HER2 status. All the cases were grouped as follows: 53 cases (30.3%) were luminal A, 33 cases (18.9%) were luminal B, 23 cases (13.1%) were HER2- overexpression and 66 cases (37.7%) were triple negative, the AR expression rate was 56.6% (30/53), 75.8% (25/33), 47.8% (11/23), 33.3% (22/66), respectively. There was significant difference among the four groups' AR expression rates. With respect to the clinico-pathological features, AR positive cases were younger in luminal A and had lower mitosis rate in triple negative subgroups than the negative cases (x2 = 4.567, P = 0.033; x2 = 5.140, P =0.023, respectively). Conclusion AR has a high positive rate in breast carcinoma, and may be an ideal therapeutic target for breast carcinoma, especially for the triple negative subtype.