Prognostic Role of Androgen Receptor in Triple Negative Breast Cancer: A Multi-Institutional Study
Prognostic Role of Androgen Receptor in Triple Negative Breast Cancer: A Multi-Institutional Study
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DOI：
10.3390/cancers11070995
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发表时间：
2019-06-26
期刊：
影响因子：
5.2
通讯作者：
Aneja, Ritu
中科院分区：
文献类型：
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作者：
Bhattarai, Shristi;Klimov, Sergey;Aneja, Ritu
背景：雄激素受体(AR)已成为AR阳性三阴性乳腺癌(TNBC)的潜在治疗靶点。然而，关于AR在TNBC中的预后作用的相互矛盾的报道使其有效性受到质疑。一些研究认为AR阳性提示TNBC预后良好，而另一些研究则相反，一些研究表明AR状态对患者预后无显著影响。方法：我们评估了来自6个国际队列(美国420例，英国239例，挪威104例，爱尔兰222例，尼日利亚180例，印度242例)的TNBC患者手术切除肿瘤AR的预后价值。用相同的免疫组织化学方法对所有TNBC样本进行相同的抗AR抗体染色，AR阳性核数为1%的样本被认为是AR阳性的TNBCs。结果：在控制了年龄、级别、人口和化疗后，AR状态显示出与患者总体生存相关的特定人群模式。我们发现AR阳性状态在美国和尼日利亚队列中是预后良好的标志，在挪威、爱尔兰和印度队列中是预后不良的标志，在英国队列中是中性的。结论：AR状态本身并不是一个可靠的预后指标。需要更多的研究来研究不同队列中的分子亚型组成。
Background: The androgen receptor (AR) has emerged as a potential therapeutic target for AR-positive triple-negative breast cancer (TNBC). However, conflicting reports regarding AR's prognostic role in TNBC are putting its usefulness in question. Some studies conclude that AR positivity indicates a good prognosis in TNBC, whereas others suggest the opposite, and some show that AR status has no significant bearing on the patients' prognosis. Methods: We evaluated the prognostic value of AR in resected primary tumors from TNBC patients from six international cohorts {US (n = 420), UK (n = 239), Norway (n = 104), Ireland (n = 222), Nigeria (n = 180), and India (n = 242); total n = 1407}. All TNBC samples were stained with the same anti-AR antibody using the same immunohistochemistry protocol, and samples with >= 1% of AR-positive nuclei were deemed AR-positive TNBCs. Results: AR status shows population-specific patterns of association with patients' overall survival after controlling for age, grade, population, and chemotherapy. We found AR-positive status to be a marker of good prognosis in US and Nigerian cohorts, a marker of poor prognosis in Norway, Ireland and Indian cohorts, and neutral in UK cohort. Conclusion: AR status, on its own, is not a reliable prognostic marker. More research to investigate molecular subtype composition among the different cohorts is warranted.