目的探讨乳腺癌组织雄激素受体(androgen receptor,AR)的表达,分析其在各分子亚型中表达的特点及其意义。方法采用免疫组织化学方法检测AR在335例乳腺浸润性导管癌石蜡包埋组织中的表达,结合66月随访情况,分析AR在五个分子亚型中表达的特点。结果乳腺癌组织中AR阳性率较高,达72.5%,尤其在ER阴性PR阴性乳腺癌病例,AR常常显示阳性(占53.2%)。较多(61.0%)basal-like型乳腺癌AR显示阴性,提示预后欠佳。在luminal Al、uminal B、basal-like以及normal-like亚型中AR阳性组出现局部复发、远处转移或死亡比例较AR阴性组少(P=0.019,0.044,0.034和0.032),生存曲线也显示了AR阳性患者预后较好(P=0.006,0.013,0.036和0.010)。结论检测乳腺癌AR的表达水平有助于改进和细化乳腺癌的分子分型,为指导个体化治疗提供理论依据。
Objective To evaluate the expression of AR(androgen receptor,AR) in different molecular subgroups of breast cancer and its significance.Methods Three hundred and thirty-five cases of invasive ductal breast carcinoma were involved in this study.Immunohistochemical expression of AR on paraffin-embedded tumor tissues was analyzed,compared with patients' outcome during 66-months' follow-up observation,and its implications were evaluated in five molecular subgroups.Results A greater percentage(72.5%) of breast cancer cases displayed nuclear immunoreactivity for AR,and AR expression was found in 53.2% of ER,PR-negative cases.The majority(61.0%) of basal-like breast cancers showed loss of AR expression,which had poor prognosis.In luminal A,luminal B,basal-like,and normal-like subgroups,the occurrence rate of relapse,metastasis and death for AR positive was lower than that of AR negative tumors(P=0.019,0.044,0.034 and 0.032 respectively).The disease-free survival curves also revealed that the patients with AR expression had a more favorable prognosis than those without it(P=0.006,0.013,0.036 and 0.010).Conclusion The detection of AR may help improve the molecular subtyping of breast cancer and provide theoretical evidence for individualized treatment.