From the Department of Breast Surgery, Shanghai Cancer Center, Fudan University, Shanghai, China (Li, Zheng, Chen, Chi, Xue, Wu).
The Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China (Li, Zheng, Chen, Chi, Xue, Wu).
Arch Pathol Lab Med. 2023 Sep 1;147(9):1075-1085. doi: 10.5858/arpa.2021-0590-OA.
CONTEXT.—: Whether androgen receptor (AR) expression can predict prognosis in breast cancer is under debate.
OBJECTIVE.—: To analyze, retrospectively, the prognostic and treatment-predictive ability of AR status in breast cancer.
DESIGN.—: A total of 5765 patients diagnosed with primary invasive breast cancer without distant metastasis in the adjuvant setting were analyzed. The propensity score-matching method was used to develop a new cohort of 3978 patients (1989 patients each) in which important prognostic factors were balanced.
RESULTS.—: Positive AR expression is an independent prognostic factor for disease-free survival and overall survival. Estrogen receptor (ER)+ and progesterone receptor (PR)+ AR+ breast cancer patients had the longest survival, whereas ER-PR-AR- breast cancer patients had the shortest survival. The ER/PR/AR combinations could not predict the treatment effects for adjuvant trastuzumab but could be used for adjuvant chemotherapy and endocrine therapy selection. The worst survival was found in ER+PR-AR- patients receiving toremifene, ER+PR-AR+ patients receiving exemestane, ER+PR+AR- patients receiving anthracycline, and ER-PR-AR+ patients receiving taxanes. ER+PR-AR-, ER-PR-AR+, and ER-PR-AR- patients were associated with the worst survival among those who received radiotherapy and anthracycline plus taxanes.
CONCLUSIONS.—: AR in combination with ER and PR could predict the prognosis and treatment effects of chemotherapy, endocrine therapy, and radiotherapy in the adjuvant setting.
雄激素受体（AR）表达能否预测乳腺癌的预后仍存在争议。
回顾性分析 AR 状态在乳腺癌中的预后和治疗预测能力。
分析了在辅助治疗中诊断为无远处转移的原发性浸润性乳腺癌的 5765 例患者。采用倾向评分匹配方法，建立了一个新的 3978 例患者队列（每组 1989 例），其中重要的预后因素得到了平衡。
AR 阳性表达是无病生存和总生存的独立预后因素。ER+和 PR+AR+乳腺癌患者的生存时间最长，而 ER-PR-AR-乳腺癌患者的生存时间最短。ER/PR/AR 组合不能预测辅助曲妥珠单抗的治疗效果，但可用于辅助化疗和内分泌治疗的选择。ER+PR-AR-患者接受托瑞米芬、ER+PR-AR+患者接受依西美坦、ER+PR+AR-患者接受蒽环类药物、ER-PR-AR+患者接受紫杉类药物的患者生存最差。在接受放疗和蒽环类药物联合紫杉类药物治疗的患者中，ER+PR-AR-、ER-PR-AR+和 ER-PR-AR-患者的生存最差。
AR 与 ER 和 PR 联合可预测辅助治疗中化疗、内分泌治疗和放疗的预后和治疗效果。
