雄激素受体在三阴性乳腺癌组织中的表达及其与临床病理特征及预后的相关性

目的:检测雄激素受体（AR）在三阴性乳腺癌（TNBC）组织中的表达情况，及其与临床病理特征及预后的相关性。方法:选取2012年至2016年间101例经病理确诊三阴性乳腺癌患者肿瘤组织标本，通过免疫组化法(IHC)检测肿瘤组织雄激素受体（AR）表达状况,分析AR表达与不同临床病理参数及预后的相关性。结果:在101例TNBC患者中，AR表达阳性患者27例(26.7%)，AR表达阴性患者74例(73.3%)。AR阳性TNBC较AR阴性TNBC更多表现为非浸润性导管癌（P=0.015）和较低的组织学分级（I/II，P=0.000）及低Ki-67表达(P=0.010)。AR阳性较AR阴性TNBC患者具有较好的无病生存期及总生存期(P=0.014,P=0.021)。单因素回归分析显示，AR阴性表达、高的组织学分级、肿瘤直径大于2 cm与不良的无进展生存期显著相关（P＜0.05）；AR阴性表达、高的组织学分级、肿瘤直径大于2 cm与不良的总生存期显著相关（P＜0.05）。多因素Cox回归分析显示,AR阳性表达为判断TNBC患者良好无进展生存期及良好总生存期的独立因素（P＜0.05）。结论:AR表达与多种临床病理因素存在相关性，AR表达对TNBC患者预后有显著影响，AR可能在三阴性乳腺癌靶向治疗中具有重要作用。

The relationship between androgen receptor expression and clinicopathologic features and prognosis in triple-negative breast cancer tissues

Objective:To detect the expression of androgen receptor (AR) in triple-negative breast cancer (TNBC) and to analyse the relationship between its expression and clinicopathologic features and prognosis.Methods:101 TNBC cases of breast spcimens were obtained from 2012 to 2016 confirmed by pathological diagnosis.Formalin-fixed,paraffin-embedded samples of tumors were tested by immunohistochemistry (IHC) as a primary estimate of AR status.The correlation between AR expression status and different clinical pathological features and clinical outcome were evaluated.Results:In the 101 TNBC patients,27(26.7%) were AR positive,and 74(73.3%) were AR negative.Compared with AR negative TNBC，in the AR positive group,non-invasive ductal carcinoma (NIDC) was more prevalent （P=0.015）.The frequency of lower grade (I/II) tumors was higher among AR positive TNBC tumors compared to AR negative tumors （P=0.000）.AR positive TNBC was more likely to have a low Ki-67 expression (P=0.010).Patients with AR positive tumor showed better DFS and OS compared to AR negative patients (P=0.014,P=0.021).Univariate regression analysis showed AR negative expression，higher histological grade,tumor diameter ＞2 cm were correlated significantly with poorer DFS.Univariate regression analysis showed AR negative expression，higher histological grade,tumor diameter ＞2 cm were correlated significantly with poorer OS.Multivariate Cox analysis showed AR expression was found to be an independent factor indicating favorable DFS and OS of prognosis in patients with TNBC.Conclusion:There was correlation of many clinical and histopathological factors with AR expression.AR expression has significant useful effect on prognosis.AR may play an important role of AR targeting therapies in TNBC.