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目的探讨乳腺癌中雄激素受体(AR)的表达程度与乳腺癌临床病理特征及乳腺癌预后的关系。方法通过组织芯片(购自上海芯超生物科技有限公司,芯片号:K14-051)收集2001年1月至2008年7月期间接受乳腺癌改良根治术的310例乳腺浸润性导管癌患者的病例资料,应用免疫组织化学技术检测癌组织中AR的表达,并采用χ2检验比较患者年龄、淋巴结转移情况及ER、P53、Ki67表达情况与AR表达程度的关系,采用非参数秩和检验比较患者分子分型、肿瘤大小、乳腺癌组织学分级与AR表达程度的关系,绘制Kaplan-Meier生存曲线研究AR表达程度对乳腺癌患者预后的影响,并用Cox比例风险回归模型探讨影响乳腺癌患者预后的独立因素。结果 AR阳性表达、弱阳性表达、阴性表达患者分别为155、100、55例,所占比例为50%(155/310)、32%(100/310)、18%(55/310)。AR的表达程度与患者年龄、分子分型、组织学分级、ER及P53表达程度有关(χ2=7.128,P=0.028;Z=56.099,P<0.001;Z=10.144,P=0.006;χ2=65.577,P<0.001;χ2=16.127,P<0.001)。Kaplan-Meier生存分析显示,不同AR表达程度的患者间OS率差异有统计学意义(χ2=11.965,P=0.003),其中AR阳性表达(81.3%)、AR弱阳性表达组(87.0%)OS率均高于AR阴性表达组(67.3%)(χ2=5.991,P=0.014;χ2=10.335,P=0.001),而AR阳性表达组与AR弱阳性表达组比较,OS率差异无统计学意义(χ2=2.386,P=0.122)。Cox回归分析显示,AR、肿瘤大小、淋巴结状态以及分子分型是乳腺癌预后的独立预测因素(OR=0.559,95%CI:0.318~0.981,P=0.043;OR=1.505,95%CI:1.047~2.161,P=0.027;OR=1.616,95%CI:1.046~2.497,P=0.030;OR=1.457,95%CI:1.023~2.076,P=0.037)。结论 AR表达程度与乳腺癌预后有关,可作为其不良预后的独立预测因子。
Objective To investigate the relationship between the expression of androgen receptor (AR) in breast cancer and the clinicopathological features of breast cancer and the prognosis of breast cancer. Methods A total of 310 breast invasive ductal carcinoma patients undergoing modified radical mastectomy from January 2001 to July 2008 were collected by tissue microarray (purchased from Shanghai Xinchao Biotechnology Co., Ltd., chip number: K14-051). The data were used to detect the expression of AR in cancer tissues by immunohistochemical technique. The χ2 test was used to compare the age, lymph node metastasis and the expression of ER, P53 and Ki67 with the expression level of AR. The non-parametric rank sum test was used to compare the molecules of patients. The relationship between classification, tumor size, histological grade of breast cancer and expression of AR, Kaplan-Meier survival curve was used to study the effect of AR expression on the prognosis of breast cancer patients, and Cox proportional hazards regression model was used to explore the independence of breast cancer patients. factor. Results There were 155, 100, and 55 patients with AR positive, weak positive, and negative expression respectively. The proportions were 50% (155/310), 32% (100/310), and 18% (55/310). The expression of AR was related to age, molecular typing, histological grade, ER and P53 expression (χ2=7.128, P=0.028; Z=56.099, P<0.001; Z=10.144, P=0.006; χ2=65.577). P<0.001; χ2=16.127, P<0.001). Kaplan-Meier survival analysis showed that there was a significant difference in OS rate among patients with different degrees of AR expression (χ2=11.965, P=0.003), among which AR positive expression (81.3%) and AR weak positive expression group (87.0%)OS The rate was higher than AR negative expression group (67.3%) (χ2=5.991, P=0.014; χ2=10.335, P=0.001). There was no significant difference in OS rate between AR positive expression group and AR weak positive expression group. (χ2=2.386, P=0.122). Cox regression analysis showed that AR, tumor size, lymph node status, and molecular typing were independent predictors of breast cancer prognosis (OR=0.559, 95%CI: 0.318-0.981, P=0.043; OR=1.505, 95% CI: 1.047 ~2.161, P=0.027; OR=1.616, 95% CI: 1.046 to 2.497, P=0.030; OR=1.457, 95% CI: 1.023 to 2.076, P=0.037). Conclusion The degree of AR expression is related to the prognosis of breast cancer and can be used as an independent predictor of poor prognosis.