Søiland Håvard, Kørner Hartwig, Skaland Ivar, Janssen Emiel A M, Gudlaugsson Einar, Varhaug Jan Erik, Baak Jan P A, Søreide Jon Arne
Department of Surgery, Stavanger University Hospital, Stavanger, Norway.
J Surg Oncol. 2008 Dec 1;98(7):551-8. doi: 10.1002/jso.21156.
Androgen receptor (AR) is relevant for prognostication in breast cancer. Different determination methods and cut-off levels hamper interpretation and comparisons of studies. Long-term prognostic evaluation of different AR assays in patients comprising operable breast cancers is scarce.
AR was evaluated in 120 primary tumors using the dextran-coated charcoal method (charc-AR), and quantitative immunohistochemistry (IHC) on whole sections (WS) and tissue microarrays (TMA). Nuclear and cytoplasmic-AR localization was determined, and the prognostic importance of AR assays was assessed. Comparisons and correlations with the mitotic activity index (MAI), estrogen receptor (ERalpha), progesterone receptor (PR), HER-2, and histological grade (WHO I-III) were made.
Nuclear-AR in WS, but not charc-AR, strongly correlated with MAI (P = 0.001). However, prognostic information appeared in univariate survival analyses only. Nuclear-AR in TMA was not prognostic. Charc-AR was independent prognostic in node positives both for relapse free survival (RFS) and breast cancer specific survival (BCSS). Both charc-AR and IHC cytoplasmic-AR provided independent prognostic survival information for BCSS in women <55 years.
Methods that can detect AR localized in the cytoplasm yield important prognostic information, and further studies in patients with operable breast cancer are warranted.
雄激素受体（AR）与乳腺癌的预后相关。不同的检测方法和临界值妨碍了研究结果的解读与比较。对于可手术乳腺癌患者，不同AR检测方法的长期预后评估较少。
采用葡聚糖包被活性炭法（charc-AR）、全切片定量免疫组化（IHC）及组织芯片（TMA）对120例原发性肿瘤中的AR进行评估。确定核内和胞质AR的定位，并评估AR检测的预后重要性。将其与有丝分裂活性指数（MAI）、雌激素受体（ERα）、孕激素受体（PR）、HER-2及组织学分级（WHO I-III级）进行比较和相关性分析。
全切片中的核AR而非charc-AR与MAI密切相关（P = 0.001）。然而，仅在单因素生存分析中显示出预后信息。组织芯片中的核AR无预后意义。charc-AR对无复发生存（RFS）和乳腺癌特异性生存（BCSS）而言，在淋巴结阳性患者中是独立的预后因素。对于年龄<55岁的女性，charc-AR和免疫组化胞质AR均为BCSS提供了独立的预后生存信息。
能够检测胞质中AR的方法可提供重要的预后信息，有必要对可手术乳腺癌患者开展进一步研究。
