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目的激素受体阴性(ER-/PR-)乳腺癌具有明显的肿瘤异质性,临床治疗手段相对有限。本研究探讨激素受体阴性乳腺癌组织中,雄激素受体(androgen receptor,AR)和HER2表达的相关性,及其与临床病理参数和预后的相关性。方法收集中国人民解放军福州总医院经手术治疗并病理确诊的乳腺癌120例,中位年龄52岁。采用FISH法检测收集的激素受体阴性乳腺癌组织HER2/neu基因状态,分为HER2阳性(HER2过表达组)和HER2阴性(三阴组)两组,每组60例。并采用EliVisionTMplus免疫组化法检测AR、Ki-67、EGFR表达,分析HER2和AR表达与临床病理参数、3年无病生存期(disease free survival,DFS)的相关性。结果 AR在激素受体阴性乳腺癌组织阳性率为61.67%(74/120),HER2过表达组和三阴组分别为73.33%(44/60)和50.00%(30/60)。激素受体阴性乳腺癌组织中,AR表达与月经状态、肿瘤大小、组织学分级、EGFR表达及HER2状态相关,均P值<0.05;在HER2过表达组中,AR表达与月经状态、淋巴结受累、EGFR表达相关,均P值<0.05;三阴组中,AR表达与肿瘤大小和组织学分级相关,均P值<0.05。Kaplan-Meier法分析显示,HER2过表达组中AR表达与患者的3年DFS呈正相关,P<0.05;Cox回归法分析结果示,肿瘤大小、淋巴结受累、EGFR表达、AR表达均与患者的3年DFS有关,P<0.05。结论 AR可能成为筛选激素受体阴性乳腺癌高危人群和预测其预后的辅助指标之一,可作为激素受体阴性乳腺癌的新治疗靶点,为不同HER2状态乳腺癌治疗提供新思路。
Objective Hormone receptor negative (ER- / PR-) breast cancer has obvious tumor heterogeneity, and the clinical treatment is relatively limited. This study was to investigate the correlation between the expression of androgen receptor (AR) and HER2 in hormone receptor negative breast cancer and its correlation with clinicopathological parameters and prognosis. Methods 120 cases of breast cancer diagnosed by operation and pathology were collected from Fuzhou General Hospital of Chinese People’s Liberation Army. The median age was 52 years. The status of HER2 / neu gene in hormone receptor negative breast cancer tissues was detected by FISH. There were 60 cases in each group, HER2 positive (HER2 overexpression) and HER2 negative (triamcinus). The expressions of AR, Ki-67 and EGFR were detected by EliVisionTMplus immunohistochemistry. The correlation between HER2 and AR expression and clinical pathological parameters and 3-year disease free survival (DFS) was analyzed. Results The positive rate of AR in hormone receptor negative breast cancer was 61.67% (74/120). The positive rate of HER2 in overexpression group was 73.33% (44/60) and that in triple negative group was 50.00% (30/60). In hormone receptor negative breast cancer tissues, AR expression was correlated with menstrual status, tumor size, histological grade, EGFR expression and HER2 status, all P values <0.05; in HER2 overexpression group, AR expression was correlated with menstrual status, lymph node involvement , P <0.05. The expression of AR was correlated with tumor size and histological grade in Sanyinjiao group (P <0.05). Kaplan-Meier analysis showed that AR expression in HER2 overexpression group was positively correlated with 3-year DFS of patients (P <0.05). Cox regression analysis showed that tumor size, lymph node involvement, EGFR expression and AR expression were all significantly correlated with patients’ Year DFS, P <0.05. Conclusion AR may be one of the auxiliary indexes for screening high-risk population of hormone receptor-negative breast cancer and predicting prognosis. AR may serve as a new therapeutic target for hormone-receptor-negative breast cancer and provide new ideas for the treatment of breast cancer with different HER2 status.