Choi Jung Eun, Kang Su Hwan, Lee Soo Jung, Bae Young Kyung
Department of Surgery, Yeungnam University College of Medicine, Daegu, South Korea.
Ann Surg Oncol. 2015 Jan;22(1):82-9. doi: 10.1245/s10434-014-3984-z. Epub 2014 Aug 22.
A subset of triple-negative breast cancer (TNBC) has been reported to express androgen receptor (AR); however, the clinical significance of AR expression in TNBC is unclear.
We examined immunohistochemical expression of AR in a large cohort of TNBC cases and correlated its expression with clinicopathologic features and clinical outcome.
AR expression was found in 17.7% (87/492) of TNBCs. Positive expression of AR showed significant correlation with older age (p < 0.001), apocrine histology (p = 0.001), and lower histologic grade (p < 0.001). AR was a poor prognostic marker for overall survival (OS) in univariate (p = 0.026) and multivariate (p = 0.008) analyses. In the lymph node-negative (n = 316) subgroup, AR expression was a significant predictor of worse OS and disease-free survival (DFS) in both univariate (p = 0.028 and 0.011) and multivariate (p = 0.024 and 0.01, respectively) analyses. AR expression also was a prognostic factor in pT1 subgroup (OS, p = 0.007; DFS, p = 0.01); however, its prognostic value was not observed in TNBC patients with lymph node metastasis or tumor size larger than pT1.
AR-expressing TNBCs represent a distinct breast cancer subgroup with adverse clinical outcome and AR blockade could be a potential endocrine therapy for these TNBC patients. Evaluation of AR status may provide additional information on prognosis and treatment in patients with TNBC.
据报道,三阴性乳腺癌(TNBC)的一个亚组表达雄激素受体(AR);然而,AR在TNBC中表达的临床意义尚不清楚。
我们检测了一大组TNBC病例中AR的免疫组化表达,并将其表达与临床病理特征及临床结局相关联。
在492例TNBC中,17.7%(87/492)检测到AR表达。AR的阳性表达与年龄较大(p < 0.001)、大汗腺组织学类型(p = 0.001)及较低的组织学分级(p < 0.001)显著相关。在单因素(p = 0.026)和多因素(p = 0.008)分析中,AR是总生存期(OS)的不良预后标志物。在淋巴结阴性(n = 316)亚组中,在单因素(p = 0.028和0.011)和多因素(p分别为0.024和0.01)分析中,AR表达均是OS和无病生存期(DFS)较差的显著预测因素。AR表达在pT1亚组中也是一个预后因素(OS,p = 0.007;DFS,p = 0.01);然而,在有淋巴结转移或肿瘤大小大于pT1的TNBC患者中未观察到其预后价值。
表达AR的TNBC代表一个具有不良临床结局的独特乳腺癌亚组,AR阻断可能是这些TNBC患者的一种潜在内分泌治疗方法。评估AR状态可能为TNBC患者的预后和治疗提供额外信息。