The Expression And Clinical Significance Of Androgen Receptor And Androgen In Breast Cancer

Objective By collaboratively detecting the expression of androgen receptor (AR) inbreast carcinoma and the serum testosterone (T)1evel (x±S) of the patients with breastcancers. To research their relationships with clinical pathological factors. Methods Selectedthe data of195patients with breast cancers which are pathologically confirmed in our hospitalfrom October2011to February2013. The carcinoma tissues without any breast cancertreatment were taken and the immunohistochemical method was used to detect the expressionof AR, estrogen receptor (ER), progesterone receptor (PR) and human epidermal growthfactor receptor-2(Her-2). According to the expression of ER, PR and Her-2, we categorized195breast cancer into4groups：Luminal A (ER/PR+，HER-2-)、Luminal B (ER/PR+,HER-2+), HER-2(ER-, PR-, HER-2+), TNBC (ER-, PR-, Her-2-). The detection of thepreoperative fasting venous blood with electrochemical luminescence reaction method wasadopted to determine the testosterone levels in serum. The statistical analysis on theexpression of two indices in four groups was performed by using the SPSS13.0softwaresystem, and was compared with the menstruation, lymph node metastasis, tumor size, andTNM stage. P <0.05showed the statistical significance.Results (1) The positive expressionrate of AR in breast cancer tissues was relatively high (60%), slightly lower than ER (67%)and higher than PR (55%). Among all the positive expressions of AR, the number of weaklypositive expressions (+) is175, while the number of the mid-positive expressions (++) is16,and the number of strongly positive expressions (+++) is4. The positive expression rates ofAR in positive ER and PR group were respectively67%(88/131) and70%(75/107), and innegative ER and PR group were44%(28/64) and47%(41/88). The rates of the positivegroup was significantly higher than that in the negative group (χ~2=9.790, P=0.002; χ~2=11.067,P=0.001). The positive expression rates of AR in positive Her-2group were respectively65%(75/116), and the positive expression rates of AR in negative Her-2group were53%(42/79). The difference between the groups was no statistically significant (χ~2=2.585, P=0.108). InLuminal A group, Luminal B group, HER-2group, TNBC group, the positive expression ratesof AR were58%(32/55),72%(57/79),52%(16/31) and37%(11/30) respectively. Thepositive rate of AR expression among groups had significant statistical difference (χ~2=12.577,P=0.006). AR expression in Luminal B group was higer than TNBC group (χ~2=11.667,P=0.001). The positive expression rate of AR in I and II stage of TNM staging group was63%(103/164) was higer than in III and IV stage was42%(13/31)(χ~2=4.712, P=0.03). Thepositive rate of AR expression was not significantly different with the tumor size, lymph nodemetastasis and menopause (χ~2=5.278, P=0.071; χ~2=2.679, P=0.102; χ~2=0.156P=0.693).(2)Among all the195patients,107cases were premenopausal women whose testosterone levelsin the serum were0.244±0.098,88cases were postmenopausal women whose testosteronelevels in the serum were0.179±0.117. A statistically significant difference between twogroups were found (t=-4.193P=0.000).195cases of breast cancer patients were divided intodifferent groups. According to the statistical analysis, the levels of testosterone in serum ofbreast cancer patients were irrelevant with the breast cancer molecular subtypes, ER, PR,Her-2,tumor size, TNM stage lymph node metastasis. Conclusions (1) AR and ER, PR arewidely expressed in breast cancer tissues, and the AR expression was associated with ER, PRexpression, the difference was statistically significant; AR expression was higer in Luminal Bgroup and in non-TNBC group than in TNBC group, and the difference was statisticallysignificant; AR expression was higer in stage I and II than in stage III and IV group, and thedifference was statistically significant; This possibly indicates that the malignancy of thebreast cancer with positive AR is low, and positive AR is expected to become an independentfactor of the prognosis of breast cancer. About its feasibility as a target of endocrine therapyand targeting therapy, especially in the case of the TNBC is still under investigating.(2) Thedifference of the levels of testosterone between premenopausal and postmenopausal patientswith breast cancer were significantly. May indicate a low testosterone level of patients withbreast cancer, the body into a small amount of estrogen and less influence the development of breast cancer, but this assumption should be further studied.