摘要
目的探讨三阴性乳腺癌(TNBC)患者中雄激素受体(AR)表达情况及临床病理特征和预后。方法回顾性分析2014年1月—2016年12月北京大学第一医院乳腺疾病中心收治的1018例早期浸润性乳腺癌患者的病例资料,其中女性1011例,男性7例,所有患者年龄范围为21~92岁,中位年龄57岁。选取其中TNBC患者,根据AR表达情况分为AR阳性组和AR阴性组,分析两组患者临床病理特征情况,包括月经情况、病理类型、T分期、淋巴结状态、解剖学分期、预后分期、Ki-67指数、组织学分级、有无脉管癌栓和神经侵犯,观察雄激素受体表达情况与临床病理特征、新辅助化疗疗效及预后的关系。临床病理特征的组间比较连续变量采用独立样本t检验,分类变量采用Pearsonχ^2检验或Fisher精确概率检验,等级变量采用Mann-Whitney U检验。生存分析采用Kaplan-Meier法,组间比较采用Log-rank检验。结果早期浸润性乳腺癌患者中TNBC患者共148例,占比14.5%,所有患者均为女性,年龄分布在27~75岁,中位年龄55岁。其中AR阳性组59例(39.9%),AR阴性组89例(60.1%)。AR阳性组与阴性组患者Ki-67指数、组织学分级和预后分期差异有统计学意义(P<0.05)。AR阳性和阴性表达与总生存(98.3%比95.4%,P=0.830)和无病生存(91.4%比91.0%,P=0.812),差异均无统计学意义。接受新辅助化疗的TNBC患者中AR阳性与pCR率显著低于AR阳性组(χ^2=4.381,P=0.046)。结论早期TNBC患者,AR表达是新辅助治疗疗效的独立预测因素,但与预后相关性尚不明确。
Objective To discuss the androgen receptor(AR)expresion and its association with clinicopathological features and prognosis in early stage triple-negative breast cancer patients(TNBC).Methods The present study retrospectively analyzed the clinic data of 1018 patients with early-stage invasive breast cancer treated at the Breast Disease Center at Peking University First Hospital between January 2014 and December 2016,including 1011 females and 7 males;the age range was 21 to 92 years,and the median age was 57 years.Patients with TNBC were enrolled,and divided into AR positive group and AR negative group according to the expression of AR.The clinicopathological features were analysed,including menopause status,pathological type,T staging,lymph node involvement,anatomic staging,prognostic staging,Ki-67 index,histological grade,vascular tumor thrombus and neuroinvation,and the correlation between the expression of AR and clinicopathological features,curative effect of neoadjuvant chemotherapy and prognosis were calculated.The Student’s t test was used to compare continuous data,the Pearsonχ^2 test or Fisher exact test was used to compare categorical variables,and the Mann-Whitney U test was used for quantitative data.The Kaplan-Meier method was used to analyze survival status,and comparisons between groups were calculated by the log-rank test.Results This study included 148 TNBC,accounting for 14.5%of all patients,in which all patients were females,and the median age was 55 years,ranging from 27 years to 75 years.The number of AR-positive TNBC was 59,accounted for 39.9%of all TNBC patients,and the numbers of AR-negative were 89,accounted for 60.1%.Ki-67 index,histological grade and prognostic stage were significantly different in AR-positive and AR-negative TNBC(P<0.05).There was no statistically significant difference between AR-positive TNBC and AR-negative TNBC in OS(98.3%vs 95.4%,P=0.830)or in DFS(91.4%vs 91.0%,P=0.812).Among TNBC who received neoadjuvant chemotherapy,AR-positive patients showed a lower pCR rate than AR-negative patients(χ^2=4.381,P=0.046).Conclusions AR expression is associated with lower respond to neoadjuvant chemotherapy in TNBC.However,the association between AR expression and prognosis in TNBCs was still not clear.
作者
向泓雨
李宗翰
辛灵
程元甲
刘倩
刘荫华
Xiang Hongyu;Li Zonghan;Xin Ling;Cheng Yuanjia;Liu Qian;Liu Yinhua(Breast Disease Center,Peking University First Hospital,Beijing 100034,China)
出处
《国际外科学杂志》
2019年第12期825-829,F0003,共6页
International Journal of Surgery
基金
北京医学奖励基金会项目(2018-0304)。
关键词
乳腺肿瘤
受体
雄激素
疾病特征
预后
Breast neoplasms
Receptors
androgen
Disease attributes
Prognosis
