Androgen receptor expression is a significant prognostic factor in estrogen receptor positive breast cancers
Androgen receptor expression is a significant prognostic factor in estrogen receptor positive breast cancers
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DOI：
10.1007/s10549-010-0761-y
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发表时间：
2010-12-01
影响因子：
3.8
通讯作者：
Sapino, Anna
中科院分区：
文献类型：
--
作者：
Castellano, Isabella;Allia, Elena;Sapino, Anna
本文的目的是评价雄激素受体(AR)表达在雌激素受体(ER)阳性乳腺癌患者内分泌治疗加或不加化疗中的预后价值。我们选择了1998至2003年间连续接受治疗的953例ER阳性乳腺癌患者。938例患者多次免疫组化证实ER在肿瘤组织中有表达。免疫组织化学方法检测AR的表达。采用Kaplan-Meier方法、logrank检验和多因素Cox模型分析AR表达对所有患者以及化疗-内分泌联合治疗和单纯内分泌治疗的患者复发时间(TTR)和疾病特异性生存(DSS)的影响。AR免疫反应阳性859例，阳性609例(70.9%)。AR的表达是膀胱癌(P=0.001)和直肠癌(P<；0.001)预后良好的重要标志。这一效应在接受化疗-内分泌治疗的患者组(Ttr(P=0.015)和DSS(P<；0.001))中尤其明显。COX模型证实AR是TTR值(P=0.003，HR 0.444，95%CI 0.258-0.765)和DSS(P<；0.001，HR 0.135，95%CI 0.054-0.337)的自变量。因此，我们把重点放在ER阳性的腔性B乳腺癌上，由于其更具侵袭性的免疫表型，可能会被选为化疗对象。在这一亚组中，AR表达显示预后较好的两组患者分别为TTR组(P=0.017，HR 0.521，95%CI 0.306~0.888)和DSS组(P=0.001，HR 0.276，95%CI 0.130~0.588)。AR表达是ER阳性乳腺癌患者预后较好的独立预后因素。
The purpose of this article is to evaluate the prognostic value of androgen receptor (AR) expression in patients with estrogen receptor (ER)-positive breast cancer, treated with endocrine therapy, with or without the addition of chemotherapy. A consecutive series of 953 patients with ER-positive breast cancer, treated between 1998 and 2003, was selected. Repeated immunohistochemistry confirmed the expression of ER in the tumor of 938 patients. AR expression was measured by immunohistochemistry. The Kaplan-Meier method, logrank test and multivariate Cox models were used to explore the impact of AR expression on time to relapse (TTR) and disease specific survival (DSS) in all patients and in subgroups treated with chemo-endocrine therapy or endocrine therapy alone. AR immunoreactivity was assessable in 859 tumors and positive in 609 (70.9%). AR expression was a significant marker of good prognosis for TTR (P = 0.001) and DSS (P < 0.001). This effect was particularly evident in the group of patients receiving chemo-endocrine therapy (TTR (P = 0.015) and DSS (P < 0.001)). Cox models confirmed AR as an independent variable for both TTR (P = 0.003, HR 0.444, 95%CI 0.258-0.765) and DSS (P < 0.001, HR 0.135, 95%CI 0.054-0.337). Thus, we focused on ER-positive luminal B breast cancer that may be selected for chemotherapy because of their more aggressive immuno-phenotype. In this subset AR expression identified a group of patients with better prognosis for TTR (P = 0.017, HR 0.521, 95%CI 0.306-0.888) and DSS (P = 0.001, HR 0.276, 95% CI 0.130-0.588). AR expression is an independent prognostic factor of better outcome in patients with ER-positive breast cancers.