Department of Biomedical Sciences and Human Oncology, University of Turin, Via Santena 7, 10126, Turin, Italy.
Breast Cancer Res Treat. 2010 Dec;124(3):607-17. doi: 10.1007/s10549-010-0761-y. Epub 2010 Feb 3.
The purpose of this article is to evaluate the prognostic value of androgen receptor (AR) expression in patients with estrogen receptor (ER)-positive breast cancer, treated with endocrine therapy, with or without the addition of chemotherapy. A consecutive series of 953 patients with ER-positive breast cancer, treated between 1998 and 2003, was selected. Repeated immunohistochemistry confirmed the expression of ER in the tumor of 938 patients. AR expression was measured by immunohistochemistry. The Kaplan-Meier method, logrank test and multivariate Cox models were used to explore the impact of AR expression on time to relapse (TTR) and disease specific survival (DSS) in all patients and in subgroups treated with chemo-endocrine therapy or endocrine therapy alone. AR immunoreactivity was assessable in 859 tumors and positive in 609 (70.9%). AR expression was a significant marker of good prognosis for TTR (P = 0.001) and DSS (P < 0.001). This effect was particularly evident in the group of patients receiving chemo-endocrine therapy (TTR (P = 0.015) and DSS (P < 0.001)). Cox models confirmed AR as an independent variable for both TTR (P = 0.003, HR 0.444, 95%CI 0.258-0.765) and DSS (P < 0.001, HR 0.135, 95%CI 0.054-0.337). Thus, we focused on ER-positive luminal B breast cancer that may be selected for chemotherapy because of their more aggressive immunophenotype. In this subset AR expression identified a group of patients with better prognosis for TTR (P = 0.017, HR 0.521, 95%CI 0.306-0.888) and DSS (P = 0.001, HR 0.276, 95% CI 0.130-0.588). AR expression is an independent prognostic factor of better outcome in patients with ER-positive breast cancers.
本文旨在评估雄激素受体 (AR) 表达在接受内分泌治疗的雌激素受体 (ER) 阳性乳腺癌患者中的预后价值，这些患者接受或未接受化疗的治疗。选择了 953 例连续系列的 ER 阳性乳腺癌患者，这些患者于 1998 年至 2003 年间接受治疗。对 938 例患者的肿瘤进行了重复免疫组织化学检查以确认 ER 的表达。通过免疫组织化学测量 AR 表达。采用 Kaplan-Meier 法、logrank 检验和多变量 Cox 模型探讨 AR 表达对所有患者以及接受化疗内分泌治疗或内分泌治疗的亚组患者的复发时间 (TTR) 和疾病特异性生存 (DSS) 的影响。可评估 859 例肿瘤的 AR 免疫反应性，其中 609 例 (70.9%) 为阳性。AR 表达是 TTR (P = 0.001) 和 DSS (P < 0.001) 的良好预后标志物。在接受化疗内分泌治疗的患者组中，这种影响尤其明显 (TTR (P = 0.015) 和 DSS (P < 0.001))。Cox 模型证实 AR 是 TTR (P = 0.003，HR 0.444，95%CI 0.258-0.765) 和 DSS (P < 0.001，HR 0.135，95%CI 0.054-0.337) 的独立变量。因此，我们专注于可能因其更具侵袭性免疫表型而被选择接受化疗的 ER 阳性 luminal B 型乳腺癌。在这个亚组中，AR 表达确定了一组 TTR (P = 0.017，HR 0.521，95%CI 0.306-0.888) 和 DSS (P = 0.001，HR 0.276，95%CI 0.130-0.588) 预后更好的患者。AR 表达是 ER 阳性乳腺癌患者更好预后的独立预测因素。
