The Expression Of Androgen Receptor (AR) In Breast Cancers And Its Relationship With Clinicopathological Features And Molecular Typing

ObjectiveThe expression of androgen receptor(AR)in breast cancer tissues was detected.The relationship between its expression and the clinicopathological characteristics of breast cancers was analyzed,and the expression difference of AR in different molecular types of breast cancers was investigated.The relationship between AR and prognosis of breast cancer patients was initially evaluated.Methods1.Collect the case data of 1,021 patients who were diagnosed as primary invasive breast cancer by pathology after surgery in the Cancer Hospital of Ningxia Medical University from January 2016 to January 2018:(1)Clinical data: Ages,gender and menstrual history.(2)Pathological data: tumor sizes,histological grade,histological type,numbers of regional lymph node metastases,clinical stage,the expression of ER,PR,HER-2,Ki-67,CK5/6 and EGFR in breast cancer tissues.(3)Follow up the breast cancer patients in 2016 that met the inclusion criteria and count their 3-year disease-free survival rate.2.Detect the expression of AR in the pathological specimens of breast patients included in the study: the two-step method of immunohistochemistry En Vision was used to detect the expression of AR in breast cancer tissues,and the pathological tissue sections were judged and reviewed by two experienced pathologists.3.SPSS17.0 software was used for statistical analysis: The ?2 test was used to analyze the relationship between AR expression and clinicopathological characteristics of breast cancer patients and to compare AR expression differences between different molecular types of breast cancer.The Cox regression model was used for univariate and multivariate survival analysis.The Kaplan-Meier method was used to draw survival curves,and log-rank test was used to test the differences between groups.Results1.After the strict inclusion and exclusion criteria screening,a total of 1021 patients with primary invasive breast cancer was included in this study,and the overall AR positive expression rate was 77.0%(786/1021).2.The current study showed that the positive rate of AR in breast cancer tissue was related to the histological grade and histological type,and the difference was statistically significant(P<0.001).There was no correlation between AR positive expression rate and patients' age,menstrual status,tumor size,regional lymph node metastasis and clinical stage(P>0.05).The positive rate of AR in breast cancer tissue was related to ER,PR,Ki-67 and HER-2,and the difference was statistically significant(P<0.001).In the 182 cases of triple-negative breast cancer,the AR positive rate was associated with CK5/6,the difference was statistically significant(P<0.001),and the AR positive rate was not related to EGFR expression(P>0.05).3.Among the 1021 breast cancer patients,the AR positive rate of Luminal A-like breast cancers was 94.0%,and the AR positive rate of Luminal B-like breast cancers was 88.0%.The positive rate of triple negative breast cancers was AR 26.9%,and the AR positive rate of HER-2 overexpressing breast cancers was 77.2%.There were differences in the positive expression rate of AR between different molecular types of breast cancer(P<0.001).The positive rate of AR in Luminal breast cancer was significantly higher than that of triple negative breast cancer and HER-2 overexpression type breast cancer,the difference was statistically significant(P<0.001).In triple-negative breast cancer,the AR positive rate of non-basal like breast cancer(50%)was higher than that of basal-like breast cancer(23.8%),the difference was statistically significant(P = 0.035).4.A total of 201 breast cancer patients met the inclusion and exclusion criteria in 2016,and were followed up for 3 years.During the follow-up period,21 breast cancer patients had local recurrence or distant metastasis,and the 3-year disease-free survival rate 89.6%.The Cox regression univariate analysis showed that the AR expression was related to DFS(HR 0.305,95% CI 0.121-0.766,P=0.008),the multivariate analysis showed that AR expression was not related to DFS(HR 1.048,95% CI 0.123-8.903,P=0.966).In the single factor analysis,ER(HR 0.262,95% CI 0.083-0.822;P=0.014),PR(HR 0.280,95% CI 0.089-0.881;P=0.021),HER-2(HR 11.403,95% CI 2.780-46.770;P<0.001)were also important predictors of DFS,and in the multivariate analysis,only HER-2((HR 12.329,95% CI 2.612-58.185;P=0.002))was still an independent prognosis of breast cancer patients.Conclusion1.There is a positive expression of AR in breast cancer tissues,and the positive rate is 77.0%.2.The AR expression is closely related to histological grade,histological type and ER,PR,HER-2,Ki-67.3.The AR expression is closely related to the breast cancer molecular typing,suggesting that AR is expected to become a new target for targeted therapy of Luminal breast cancers and provide a new therapeutic approach for non-basal cell like triple negative breast cancer.4.The AR expression may be related to the prognosis of breast cancer patients.