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雄激素受体在男性乳腺癌中的表达:缺乏临床病理相关性。

Androgen receptor expression in male breast carcinoma: lack of clinicopathological association.

作者信息

Pich A, Margaria E, Chiusa L, Candelaresi G, Dal Canton O

机构信息

Department of Biomedical Sciences and Human Oncology, University of Turin, Italy.

出版信息

Br J Cancer. 1999 Feb;79(5-6):959-64. doi: 10.1038/sj.bjc.6690153.

Abstract

Androgen receptor (AR) expression was retrospectively analysed in 47 primary male breast carcinomas (MBCs) using a monoclonal antibody on formalin-fixed, paraffin-embedded tissues. AR immunopositivity was detected in 16 out of 47 (34%) cases. No association was found with patient age, tumour stage, progesterone receptor (PGR) or p53 protein expression. Well-differentiated MBCs tended to be AR positive more often than poorly differentiated ones (P = 0.08). A negative association was found between ARs and cell proliferative activity: MIB-1 scores were higher (25.4%) in AR-negative than in AR-positive cases (21.11%; P = 0.04). A strong positive association (P = 0.0001) was found between ARs and oestrogen receptors (ERs). In univariate analysis, ARs (as well as ERs and PGRs) were not correlated with overall survival; tumour histological grade (P = 0.02), size (P = 0.01), p53 expression (P = 0.0008) and MIB-1 scores (P = 0.0003) had strong prognostic value. In multivariate survival analysis, only p53 expression (P = 0.002) and histological grade (P = 0.02) retained independent prognostic significance. In conclusion, the lack of association between AR and most clinicopathological features and survival, together with the absence of prognostic value for ER/PGR status, suggest that MBCs are biologically different from female breast carcinomas and make it questionable to use antihormonal therapy for patients with MBC.

摘要

利用单克隆抗体对47例原发性男性乳腺癌(MBC)的福尔马林固定石蜡包埋组织进行雄激素受体(AR)表达的回顾性分析。47例中有16例(34%)检测到AR免疫阳性。未发现与患者年龄、肿瘤分期、孕激素受体(PGR)或p53蛋白表达存在关联。高分化MBC比低分化MBC更倾向于AR阳性(P = 0.08)。发现AR与细胞增殖活性呈负相关:AR阴性病例的MIB-1评分(25.4%)高于AR阳性病例(21.11%;P = 0.04)。发现AR与雌激素受体(ER)之间存在强正相关(P = 0.0001)。单因素分析中,AR(以及ER和PGR)与总生存期无关;肿瘤组织学分级(P = 0.02)、大小(P = 0.01)、p53表达(P = 0.0008)和MIB-1评分(P = 0.0003)具有较强的预后价值。多因素生存分析中,只有p53表达(P = 0.002)和组织学分级(P = 0.02)保留独立的预后意义。总之,AR与大多数临床病理特征及生存缺乏关联,以及ER/PGR状态缺乏预后价值,提示MBC在生物学上与女性乳腺癌不同,这使得对MBC患者使用抗激素治疗存在疑问。

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