Hwang Ki-Tae, Kim Young A, Kim Jongjin, Park Jeong Hwan, Choi In Sil, Hwang Kyu Ri, Chai Young Jun, Park Jin Hyun
Department of Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, 39, Boramae-Gil, Dongjak-gu, Seoul 156-707, Korea.
Department of Pathology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 156-707, Korea.
J Clin Med. 2020 Apr 10;9(4):1083. doi: 10.3390/jcm9041083.
We investigated the prognostic influence of androgen receptor (AR) on breast cancer. AR status was assessed using immunohistochemistry with tissue microarrays from 395 operable primary breast cancer patients who received curative surgery. The Kaplan-Meier estimator was used to analyze the survival rates and a log-rank test was used to determine the significance of the differences in survival. The Cox proportional hazards model was used to calculate the hazard ratio (HR) and the 95% confidence interval (CI) of survival. There were 203 (51.4%) subjects with a low expression of AR, and 192 patients (48.6%) with a high expression rate. The high AR expression group showed superior overall survival ( = 0.047) and disease-free survival ( = 0.004) when compared with the low AR expression group. The high AR expression group showed superior systemic recurrence-free survival when compared with the low AR expression group ( = 0.027). AR was an independent prognostic factor for both overall survival (HR, 0.586; 95% CI, 0.381-0.901; = 0.015) and disease-free survival (HR, 0.430; 95% CI, 0.274-0.674; < 0.001). A high AR expression was a significant favorable prognostic factor only in the subgroups with positive hormone receptors (HRc) and negative human epidermal growth factor receptor 2 (HER2) when considering disease-free survival ( = 0.026). The high AR expression group was significantly associated with superior overall survival and disease-free survival when compared with the low AR expression group with breast cancer patients. AR was a significant independent prognostic factor for both overall survival and disease-free survival. The prognostic impact of AR was valid in the HRc(+)/HER2(-) subtype when considering disease-free survival. These findings suggest the clinical usefulness of AR as a prognostic marker of breast cancer in clinical settings.
我们研究了雄激素受体(AR)对乳腺癌的预后影响。采用免疫组织化学方法,利用接受根治性手术的395例可手术原发性乳腺癌患者的组织芯片评估AR状态。采用Kaplan-Meier估计量分析生存率,采用对数秩检验确定生存差异的显著性。使用Cox比例风险模型计算风险比(HR)和生存的95%置信区间(CI)。有203例(51.4%)受试者AR低表达,192例患者(48.6%)AR高表达。与AR低表达组相比,AR高表达组的总生存期(P = 0.047)和无病生存期(P = 0.004)更优。与AR低表达组相比,AR高表达组的无全身复发生存期更优(P = 0.027)。AR是总生存期(HR,0.586;95% CI,0.381 - 0.901;P = 0.015)和无病生存期(HR,0.430;95% CI,0.274 - 0.674;P < 0.001)的独立预后因素。在考虑无病生存期时,高AR表达仅在激素受体阳性(HRc)和人表皮生长因子受体2(HER2)阴性的亚组中是显著的有利预后因素(P = 0.026)。与乳腺癌患者的AR低表达组相比,AR高表达组与更优的总生存期和无病生存期显著相关。AR是总生存期和无病生存期的显著独立预后因素。在考虑无病生存期时,AR的预后影响在HRc(+)/HER2(-)亚型中是有效的。这些发现提示了AR作为乳腺癌临床预后标志物的临床实用性。