Ki-67和 AR 在三阴性乳腺癌中的表达及与复发的关系

目的：探讨增殖细胞抗原（Ki-67）和雄激素受体（AR）在三阴性乳腺癌（TNBC）的表达及其与术后复发之间的关系。方法回顾性分析中山大学附属江门医院2006年1月至2010年12月66例TNBC 和215例非三阴性乳腺癌（NTNBC）病理标本，采用免疫组织化学法检测 Ki-67和 AR 在其组织中的表达情况，并通过随访分析 TNBC 复发与 Ki-67和 AR 表达之间的关系，结果采用 SPSS 19．0进行统计分析。结果 TNBC 组织中 Ki-67阳性率为75．76％（50／66），明显高于其在 NTNBC 组织中的阳性率62．33％（134／215，χ2＝4．031，P ＝0．045）；TNBC 组织中 AR 阳性率为31．82％（21／66），明显低于其在NTNBC 组织中的阳性率76．28％（164／215，χ2＝44．382，P ＜0．001）。TNBC 组织中 Ki-67的表达与组织学分级（χ2＝6．031，P ＝0．049）、肿瘤直径（χ2＝6．630，P ＝0．036）、淋巴节状态（χ2＝5．440，P ＝0．020）有关；AR 的表达与绝经状态（χ2＝5．341，P ＝0．021）、体重指数（χ2＝4．369，P ＝0．037）相关。TNBC 术后复发与 Ki-67的表达有关（χ2＝4．125，P ＝0．042），与 AR 表达无关（χ2＝1．257，P ＝0．262）。结论 Ki-67的高表达和 AR 的低表达在TNBC中具有明显特征，Ki-67阳性患者更易复发，可作为预测 TNBC 术后复发的指标。

Ki-67 and AR expression and its relationship with recurrence in triple-negative breast cancer

Objective To investigate the expressions of cellular proliferative antigen (Ki-67)and androgen receptor (AR)in triple-negative breast cancer (TNBC)and their relationships with recurrence. Methods Sixty-six cases of TNBC and two hundred and fifteen cases of non triple-negative breast cancer (NTNBC)tissues between January 2006 and December 2010 in Jiangmen Hospital Affiliated to Sun Yat-sen University were collected,the expressions of Ki-67 and AR were detected by immunohistochemical,and through follow-up the relationships between TNBC recurrence and the expressions of Ki-67 and AR were analyzed.SPSS 19.0 was used to analyze the results.Results The positive rate of Ki-67 in TNBC (75.76%,50 /66)was significantly higher than that in NTNBC (62.33%,134 /215,χ2 =4.031,P =0.045),and Ki-67 expression was correlated with histological grade (χ2 =6.031,P =0.049),tumor diameter (χ2 =6.630,P =0.036)and lymph node metastasis (χ2 =5.440,P =0.020).The positive rate of AR in TNBC (31.82%,21 /66)was significantly lower than that in NTNBC (76.28%,164 /215,χ2 =44.382,P <0.001),and AR expression was correlated with menopausal status (χ2 =5.341,P =0.021 )and body mass index (χ2 =4.369,P =0.037).TNBC recurrence was related to Ki-67 expression (χ2 =4.125,P =0.042),and was not related to AR expression (χ2 =1.257,P =0.262).Conclusion High expression level of Ki-67 and low expression level of AR are characteristics of TNBC.Ki-67 positive patients are more likely to relapse,and it can be used as an indicator to predict TNBC recurrence.