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目的 :探讨雄激素受体(androgen receptor,AR)在人表皮生长因子受体-2(human epidermal growth factor receptor-2,Her-2)过表达型乳腺癌中的表达情况及其预后意义。方法 :选取102例Her-2过表达型乳腺癌患者作为观察组,并取同期40例三阴性乳腺癌患者作为对照组。采用免疫组织化学法检测2组肿瘤组织中AR的表达情况,并分析观察组中AR表达与患者临床病理特征及预后的相关性。结果 :观察组的AR阳性率明显高于对照组(75.5%vs 32.5%,P<0.05)。观察组中AR阳性者与AR阴性者相比具有较低的淋巴结转移率及Ki-67值(P值均<0.05)。单因素分析结果显示,AR阳性的Her-2过表达型乳腺癌患者的5年无疾病生存(disease-free survival,DFS)率明显低于AR阴性者(71.7%vs 89.8%,P<0.05)。多因素分析结果显示,肿瘤大小和淋巴结转移是影响Her-2过表达型乳腺癌患者5年DFS时间和总生存(overall survival,OS)时间的独立预后因素(P值均<0.05);AR与Her-2过表达型乳腺癌患者的5年DFS具有相关性(χ~2=5.736,P=0.017)。结论 :Her-2过表达型乳腺癌中AR阳性患者的预后较差,提示AR可能成为治疗这类乳腺癌的新靶点。
Objective: To investigate the expression of androgen receptor (AR) in human epidermal growth factor receptor-2 (Her-2) overexpression breast cancer and its prognostic significance. Methods: 102 cases of Her-2 overexpression breast cancer patients were selected as observation group and 40 cases of triple negative breast cancer patients as control group. Immunohistochemistry was used to detect the expression of AR in the two groups of tumor tissues. The correlation between the expression of AR in the observation group and the clinicopathological features and prognosis was also analyzed. Results: The positive rate of AR in the observation group was significantly higher than that in the control group (75.5% vs 32.5%, P <0.05). There was a lower lymph node metastasis rate and Ki-67 value in AR-positive and AR-negative patients in the observation group (all P <0.05). Univariate analysis showed that the 5-year disease-free survival (DFS) rate of AR positive Her-2 overexpression breast cancer patients was significantly lower than that of AR negative patients (71.7% vs 89.8%, P <0.05) . Multivariate analysis showed that tumor size and lymph node metastasis were independent predictors of 5-year DFS and overall survival (OS) in patients with Her-2 overexpression breast cancer (P <0.05). AR and Five-year DFS was associated with Her-2 overexpression in breast cancer (χ ~ 2 = 5.736, P = 0.017). Conclusions: The prognosis of AR-positive patients with Her-2 overexpression breast cancer is poor, suggesting that AR may be a new target for the treatment of this type of breast cancer.