Center for Breast Cancer, National Cancer Center, Goyang, Korea.
Biostatistics Collaboration Team, Research Core Center, Research Institute of National Cancer Center, Goyang, Korea.
Cancer Res Treat. 2023 Apr;55(2):542-550. doi: 10.4143/crt.2022.834. Epub 2022 Sep 8.
This study investigated pathological complete response (pCR) according to androgen receptor (AR) in breast cancer patients undergoing neoadjuvant chemotherapy and estimated the relationship between AR expression and clinicopathological factors.
We identified 624 breast cancer patients who underwent surgery after neoadjuvant chemotherapy at the National Cancer Center in Goyang, Korea from April 2016 to October 2019. We retrospectively collected the clinicopathologic information and AR expression results and analyzed the data according to cancer stage, hormonal receptor (HR) status, human epidermal growth factor receptor 2 (HER2) status, tumor subtype, and pCR.
Among the 624 breast cancer patients, 529 (84.8%) were AR-positive (AR+) patients and 95 (15.2%) were AR-negative (AR-) patients. AR+ patients showed more estrogen receptor (ER) positivity, progesterone receptor (PR) positivity, HER2-positivity, and HR-positive and HER2-negative (HR+/HER2-) subtype. The rate of pCR was 31.4% (196/624). AR- patients had a significantly higher rate of pCR than AR+ patients (AR- 43.2% vs. AR+ 29.3%, p=0.007). The tumor factors associated with pCR were early stage, histologic grade 3, ER-negative, PR-negative, AR-negative, HER2-positive, and high Ki-67 values. In univariable analysis, AR+ significantly decreased the state of pCR (odds ratio, 0.546; 95% confidence interval, 0.349 to 0.853; p=0.008). According to tumor subtype, AR- tumor showed higher pCR rate in HR+/HER2- subtype (AR- 28.6% vs. AR+ 7.3%, p=0.022).
AR expression is predominant in the HR+/HER2- subtype. AR- is significantly associated with the pCR rate in breast cancer patients, especially within HR+/HER2- subtype. When determining neoadjuvant chemotherapy for the HR+/HER2- subtype, AR expression can be considered as a pCR predictive marker.
本研究旨在探讨接受新辅助化疗的乳腺癌患者中雄激素受体（AR）的病理完全缓解（pCR），并评估 AR 表达与临床病理因素之间的关系。
我们在韩国高阳市国家癌症中心回顾性地收集了 2016 年 4 月至 2019 年 10 月期间接受新辅助化疗后行手术的 624 例乳腺癌患者的临床病理信息和 AR 表达结果，并根据癌症分期、激素受体（HR）状态、人表皮生长因子受体 2（HER2）状态、肿瘤亚型和 pCR 对数据进行了分析。
在 624 例乳腺癌患者中，529 例（84.8%）为 AR 阳性（AR+）患者，95 例（15.2%）为 AR 阴性（AR-）患者。AR+患者的雌激素受体（ER）阳性、孕激素受体（PR）阳性、HER2 阳性和 HR 阳性及 HER2 阴性（HR+/HER2-）亚型比例更高。pCR 率为 31.4%（196/624）。与 AR+患者相比，AR-患者的 pCR 率显著更高（AR-43.2% vs. AR+29.3%，p=0.007）。与 pCR 相关的肿瘤因素包括早期肿瘤分期、组织学 3 级、ER 阴性、PR 阴性、AR 阴性、HER2 阳性和 Ki-67 高值。单变量分析显示，AR+显著降低了 pCR 状态（比值比，0.546；95%置信区间，0.349 至 0.853；p=0.008）。根据肿瘤亚型，HR+/HER2- 亚型中 AR-肿瘤的 pCR 率更高（AR-28.6% vs. AR+7.3%，p=0.022）。
AR 表达主要存在于 HR+/HER2- 亚型中。AR-与乳腺癌患者的 pCR 率显著相关，尤其是在 HR+/HER2- 亚型中。在确定 HR+/HER2- 亚型的新辅助化疗时，可以考虑 AR 表达作为 pCR 预测标志物。
