Department of Anatomic Pathology, Multimedica IRCCS, Milan, Italy.
Virchows Arch. 2010 Oct;457(4):467-76. doi: 10.1007/s00428-010-0964-y. Epub 2010 Aug 31.
The estrogen receptor (ER)/progesterone receptor (PR)-negative breast carcinomas (BCs) encompass three molecular subtypes: one with human epidermal growth factor receptor 2 (HER) overexpression, one normal like, and the triple negative. The androgen receptor (AR) is expressed in 70-90% of invasive BCs. The aim of our study is to detect the expression of AR in a series of ER/PR-negative BCs to ascertain if there is clinical significance in relation to BC molecular subtypes. A immunohistochemical study for all receptors and cytokeratin expression was performed in 232 cases of ER/PR-negative BCs. According to cytokeratin expression, BCs were classified into two groups: luminal-type BCs (44.2%) and basal-like-type BCs (55.8%). According to the expression of HER2, 59.3% were triple-negative BCs (when ER, PR, and HER2 were negative) and 40.7% were HER2-positive BCs. AR expression was observed in 128 tumors (56.6%). One hundred and ten cases (48.8%) had >10% and 18 (7.8%) had <10% of positively stained cells. AR immunoreactivity was found in 31.2% basal-like BCs, while in the luminal group 71.1% of cases were positive, showing highly significant correlation (p < 10⁻⁸). Regarding HER2 status, 76.7% of HER2-positive BC cases were AR positive compared with only 30.4% of triple-negative BC types, showing a strong statistically significant correlation. In conclusion, we show that AR is frequently expressed in ER/PR-negative BCs and that expression of HER2 and AR is highly correlated (p < 0.005). Our results point out the role of AR and HER2 in the pathogenesis of BCs and suggest the potential role of AR in clinical management of ER/PR-negative BCs.
雌激素受体(ER)/孕激素受体(PR)阴性乳腺癌(BC)包括三个分子亚型:一个是表皮生长因子受体 2(HER)过表达,一个是正常样的,另一个是三阴性的。雄激素受体(AR)在 70-90%的浸润性 BC 中表达。我们的研究目的是检测一系列 ER/PR 阴性 BC 中 AR 的表达,以确定其与 BC 分子亚型相关的临床意义。对 232 例 ER/PR 阴性 BC 进行了所有受体和细胞角蛋白表达的免疫组织化学研究。根据细胞角蛋白的表达,BC 分为两组:腔型 BC(44.2%)和基底样型 BC(55.8%)。根据 HER2 的表达,59.3%为三阴性 BC(当 ER、PR 和 HER2 均为阴性时),40.7%为 HER2 阳性 BC。观察到 128 个肿瘤(56.6%)中有 AR 表达。110 例(48.8%)有>10%的阳性染色细胞,18 例(7.8%)有<10%的阳性染色细胞。AR 免疫反应性在 31.2%的基底样 BC 中发现,而在腔型组中,71.1%的病例为阳性,相关性显著(p<10⁻⁸)。关于 HER2 状态,76.7%的 HER2 阳性 BC 病例为 AR 阳性,而三阴性 BC 类型仅为 30.4%,相关性具有统计学意义。总之,我们发现 AR 经常在 ER/PR 阴性 BC 中表达,并且 HER2 和 AR 的表达高度相关(p<0.005)。我们的结果指出了 AR 和 HER2 在 BC 发病机制中的作用,并表明 AR 在 ER/PR 阴性 BC 的临床管理中具有潜在作用。