Identification Of Expression Of Androgen Receptor In Male Breast Cancer

Objective: It is well known that breast cancer is a hormone dependent malignant tumor.Male breast cancer accounting for 0.5%-1.0% of breast cancer,has the characteristics of late treatment,early metastasis and poor prognosis.In recent years,the role of androgen and androgen receptor in the development of breast cancer has attracted the attention of researchers.Androgen is the main sex hormone in male,and it plays a biological role by androgen receptor(AR).Studies have shown that AR has a high positive expression rate in breast cancer tissues.Some scholars have proposed the hypothesis that androgen can inhibit the proliferation of tumor cells through AR expression in MBC.However,the role of AR in the treatment and prognosis is not clear.What is the relationship between the expression of AR and the clinicopathological parameters of MBC? What is the relationship between the expression of AR and the prognosis of MBC? In this paper,we retrospectively analyzed the clinical pathological and follow-up data of 31 cases of MBC in our hospital,in order to study the relationship between the expression of AR and the clinicopathological characteristics of MBC and prognosis,so as to provide a new way for the diagnosis and treatment of MBC.Methods: MBC patients was followed in this retrospective study from October 20003 to October 2015 at breast cancer center of the Fourth Hospital of Hebei Medical University(China).Follow-up contents included age,size of tumor,pathological classification,histological grades,TNM stages,lymphatic metastasis,molecular classification,disease-free survival(DFS),overall survival(OS).In this study,recurrence and metastasis or death were defined as endpoint events.Disease-free survival(DFS)was from the date when breast cancer was diagnosed to the date when recurrence and metastasis happened.If there was no recurrence and metastasis,the end date was the end of follow-up or death.Overall survival(OS)was from the date when breast cancer was diagnosed to the date of death.No endpoint events happened at the end of follow-up was defined censored.According to 2013 St Gallen consensus,immunohistochemistry was used to determine the status of ER,PR,AR,Ki-67 and HER2 in patients.The tumor staging is according to the American Cancer Association(AJCC)TNM staging method for male breast cancer.Fisher exact test was used to analyze the correlation between AR and clinicopathological features.The Kaplan-Meier test and long-rank was used to analyze statistical difference between different groups,such as the disease-free survival between sporadic breast cancer patients and healthy controls.P value under 0.05 was considered statistically significant.As to Multi factor analysis,Forward stepwise Cox proportional hazard model was used to compare the differences(P value of < 0.05 was considered statistically significant.).All of the statistical analysis was done with the SPSS version21.0 software package(SPSS Company,Chicago,IL).Results:1 The expression of AR AR expression positive ratio accounting for 74.2% in male patients of breast cancer.2 The relationship between AR and clinical pathological parameters.The 31 cases with male breast cancer were divided into 2 groups according to Histological grade,I-II group with19 cases and III group with 12 cases.The expression difference of AR in above two groups was of statistical significance,with Fisher exact test,P<0.05.AR expression was significantly correlated with the Histological grade of male breast cancer.The expression of AR was not associated with the age of patient,tumor size,different subtypes of breast cancer,lymph node metastasis,TNM stage,Molecular subtypes and the expression of ER,PR,HER2 and Ki-67,with P>0.05.3 Survival analysis AR and Kaplan Meier survival curves:Make Kaplan Meier survival curves defining patients’ survival rate for the vertical axis,DFS and OS for the horizontal axis.There is no difference between AR positive and AR negative group on both DFS and OS by log rank test in male breast cancer.Multivariate analysis of COX regression model of DFS and OS in male breast cancer: Cox’s multivariate regression analysis model shows that the lymph node metastasis is a independent prognostic risk factor of disease-free survival in male breast cancer patients,with P=0.038,RR=3.074.While TNM stage is not independent risk factors of overall survival in male breast cancer patients.Conclusion:1 AR positive in patients accounted of most in the male breast cancer.2 The expression of AR was statistically difference in 2 different group of Histological grading.There is relationship between histological grading in male breast cancer.The expression of AR was not associated with the age of patient,tumor size,different subtypes of breast cancer,lymph node metastasis,TNM stage,Molecular subtypes and the expression of ER,PR,HER2 and Ki-67.3 There is no relationship between AR and DFS and OS in male breast cancer.It could not be proved that AR is a indicator for the prognosis of breast cancer.4 Multivariate logistic regression analysis using COX proportional hazards regression model showed that the number of lymph node metastasis was an independent prognostic factor of disease-free survival of male breast cancer(P<0.05)...