摘要目的 以淋巴结转移及c-erbB2表达情况作为病例分组依据,探讨雄激素受体(AR)在乳腺癌预后中的价值.方法 回顾性分析2003年1月至6月连续收治的原发性女性乳腺癌患者184例,收集其临床资料,采用免疫组化方法检测化疗前乳腺癌组织的雌激素受体(ER)、孕激素受体(PR)、AR、c-erbB2蛋白表达,以淋巴结状况及c-erbB2蛋白表达情况分组,探讨AR表达与淋巴结状况、c-erbB2蛋白表达的关系及AR对生存率的影响.结果 184例均获随访5年以上,随访率100%.全组淋巴结转移率为45.1%,5年远处转移率为16.9%,5年生存率为86.4%.将184例分为淋巴结阴性及受累两组,x2检验表明AR表达情况与淋巴结状况低度相关(P＜0.05,r,=-0.236),淋巴结阳性者AR表达率低.Kaplan-Meier分析表明在淋巴结阴性组,AR表达对预后分析无影响;在淋巴结受累组,AR阳性组5年生存率及中位生存时间均优于阴性组(89.3%比67.3%和56个月比37个月).将184例分为c-erbB2表达阴性及阳性两组,同样发现在c-erbB2表达阴性组,AR表达对预后无影响;在c-erbB2表达阳性组,AR阳性组5年生存率及中位生存时间均优于阴性组(80.0%比57.1%和57个月比37个月).结论 在预后相对较差的淋巴结受累及c-erbB2表达阳性的患者中,AR表达对进一步分析预后有一定价值,AR表达阳性者预后好于阴性病例.

abstractsObjective To evaluate the prognostic significance of androgen receptor (AR)expression in patients with breast cancer. Methods The clinicopathological data of 184 consecutive female patients with primary breast cancer treated from January 9003 to June 2003 were analyzed retrospectively.The expression of estrogen receptor ( ER), progesterone receptor ( PR ), AR and c-erbB2 protein were assessed in breast cancer tissue before chemotherapy by using immunohistochemistry methods. The correlations between AR expression and lymph node status, c-erbB2 expression in patients who were classified as two subsets according to the lymph node status and c-erbB2 over-expression and the prognostic significance of AR expression were analyzed. Results All the 184 patients were followed up for more than 5 years. The lymph node involvement, 5-year metastasis and 5-year survival rate were 45. 1%, 16. 9% and 86. 4%, respectively. The 184 patients were classified as two subsets of node-negative and node-positive group. The Chi-square test showed an lowly inverse correlation between AR and lymph node status ( P ＜0. 05, r, = -0. 236), AR expression rate was lower in patients with positive nodes. The Kaplan-Meier test showed that AR expression had no influence on prognosis in lymph node-negative patients. In patients with positive nodes, the ones with AR-positive tumors had significantly better survival rate( P ＜0. 05 ), and the 5-year survival rate and the median survival time of patients with AR-positive tumors were significantly better than those of patients with AR-negative tumors(89. 3% vs. 67. 3% and 56 months vs. 37 months). When the patients were classified as two subsets: c-erbB2-negative and c-erbB2-positive, it indicated that AR expression had on impact on prognosis in c-erbB2-negative patients; and in c-erbB2-positive patients, the survival status was significantly better in patients with AR-positive breast cancer, the 5-year survival rate and the median survival time of patients with AR-positive tumors were significantly better than those of patients with AR-negative tumors(80. 0% vs. 57. 1% and 57 months vs. 37 months). Conclusions The patients with positive lymph nodes and positive c-erbB2 expression have a poorer prognosis in the female breast cancer patients, and the expression of AR has a prognostic significance in those patients. The patients with AR-positive tumors have a better prognosis than these with AR-negative tumors.