Expression And Significance Of AR In Breast Cancer

Objectives:To detect the level of expression of androgen receptor(AR) in invasive breast cancer, compare the difference of expression of AR in each molecular subtypes of breast cancer, analyze the relationship between AR and various clinicopathological parameters, discuss the diagnostic and prognostic significance of AR in invasive breast cancer.Methods:176 cases of invasive breast cancer who were received surgery operation were collected from January 2008 to March 2013 in the First Affiliate Hospital of Jinan University. 176 cases include Luminal A subtype 38 cases, Luminal B subtype 80 cases, HER-2 overexpression subtype 17 cases and Triple negative breast cancer(TNBC) 41 cases.The follow up time was from 15 to 96 months,the median follow up time was 61.5 months, the mean follow up time was 60.8 months.The expression of AR in breast cancer paraffin-embedded sections was detected by EnVision immunohistochemical staining. The relationship between AR and various clinicopathological parameters were analyzed,compare different expression level in patients with AR 5 years disease-free survival and overall survival, assess the prognostic value of AR expression in breast cancer patients.Results:1. Of 176 cases, the positive rates of AR expression were 54.5%(96/176). In the Luminal A, Luminal B, HER-2 overexpression and TNBC subtype,the positive rates of AR were 71.1%、 63.8%、 35.3% and 29.3%.AR expression in each molecular subtypes of breast cancer there was statistically significant(c2=20.017,P<0.001).2. AR-positive cases has earlier clinical stages,better histological grading and lower rate of lymph node metastasis.AR correlated positively with estrogen receptor(ER) and progesterone receptor(PR); negatively with tumor size and Ki-67(P<0.05).There were no significance found between AR with age, menstrual status,lymphovascular invasion and HER-2 status(P>0.05).3. In 176 cases,AR-positive and AR-negative patients’ 5 years disease free survival rate were 83.8% and 65.2%,5 years overall survival rate were 86.3% and66.7%. In 41 TNBC patients,AR-positive and AR-negative patients’ 5 years disease free survival rate were 82.5% and 52.4%,5 years overall survival rate were 83.3% and56.4%.In non-TNBC patients,AR-positive and AR-negative patients’ 5 years disease free survival rate were 84.8% and 73.7%,5 years overall survival rate were 87.7% and74.5%.In 176 cases,AR(-)、AR(+)and AR(++~+++)patients’ 5 years disease free survival rate were 65.2%、76.8% and 90.9%,5 years overall survival rate were66.7% 、 81.1% and 91.0%.Using the Log-rank test, the difference were statistical significant(P<0.05).4. Univariate analysis showed that AR,tumor size,lymph nodes status,clinical stages, histological grading, ER, PR, Ki-67 and HER-2 as significant predictors of disease free survival.In addition,multivariate analysis showed that clinical stages,lymph nodes status and AR were the independent factors for the disease free survival of breast cancer. The hazard ratio of AR was 0.366.Conclusion:1. Most of AR expressed in Luminal subtype breast cancer, AR-positive cases in breast cancer have earlier clinical stage,lower rate of lymph node metastasis, better histopathological grading and the lower malignancy.2. AR-positive cases have better outcomes in terms of 5 years disease free survival and overall survival. AR were the independent factors for the disease free survival of breast cancer.