| Objective:1. To discuss the correlation between the expression of androgen receptor (AR) and the clinicopathologic characteristics, the way of recurrence and metastasis as well as survival prognosis in hormone receptor-negative(ER-/PR-)breast cancer of various HER-2statuses.2. To investigate the TCM constitution types distribution of ER-/PR-breast cancer, and analysis the relationship of TCM constitution with the prognosis and the expression of AR.Methods:Collect120cases of clinical data about ER-/PR-breast cancer, which were confirmed by pathology department of Fuzhou General Hospital of Nanjing Military Command from January2009to December2010. According to TCM Constitution Scale created by professor Qi Wang, these patients’TCM constitution were investigated by means of questionnaire survey. The expression level of AR was assayed through immuno-histochemistry, as well the associations between AR expression and clinicopathologic features, the way of recurrence and metastasis, prognosis and TCM constitution types were also analyzed. Finally, all data was analyzed using SPSS16.0statistical software.Results:1. The positive rate of AR was61.67%in ER-/PR-breast cancer, it was correlated with postmenopausal status, small tumor size, low histological grade of the tumor and HER-2-positive expression (P﹤0.05). Furthermore, the rate of AR expression in HER-2-positive and HER-2-negative cases was respectively73.33%and50.00%(P﹤0.05). In HER-2-positive cases AR was associated with menstrual status and lymph node metastasis (P<0.05), but there was positive correlation with tumor size and histological grade in HER-2-negative cases (P<0.05).2. AR-negative group had higher recurrence rate in ER-/PR-breast cancer (P﹤0.05), however, this result was not found in HER-2-negative and HER-2-positive cases (P﹤0.05), was also not between AR expression and the way of recurrence and metastasis (P﹤0.05).3. Cox analysis indicated that tumor size, lymph node metastasis, TNM stage, AR expression were independent prognostic factors influencing3-year DFS of ER-/PR-breast cancer (P﹤0.05). 4. Kaplan-Meier analysis data showed that AR-positive group have a more favorable prognosis (HR:2.538,95CI:1.382-4.659, P﹤0.05). This result was also found among patients with HER-2-positive tumor (P﹤0.05), whereas it was no significant relationship between AR expression and3-year DFS in HER-2-negative cases (P﹤0.05).5. The frequency of TCM constitution types of ER-/PR-breast cancer patients in descending order was:blood-stasis type, qi-depression type, wetness-heat type, phlegm-wet type, gentleness, qi-deficency type, yang-deficiency type, yin-deficiency type. HER-2-positive patients were mostly composed of blood-stasis constitution, qi-depression constitution and phlegm-wet constitution. However, HER-2-negative cases mainly consisted of wetness-heat constitution, phlegm-wet constitution and qi-depression constitution.6. It was no association of TCM constitution and3-year DFS (P<0.05). Blood-stasis is was the main constitution of AR-positive cases, The most constitution of AR-negative cases was qi-depression and phlegm-wet(P<0.05).Conclusion:1. Whether HER-2status, ER-/PR-breast cancer had high level of AR expression, and the percentage of AR expression in HER-2-positive cases was higher than HER-2-negative. The negative expression of AR indicated poorly differentiation, more invasiveness and prone to metastasis and shorter3-year DFS.2. AR would probably be an auxiliary biomarker screening high-risk groups rather than HER-2, and play a potential role in the clinical management of women patients with ER-/PR-breast cancer.3. The constitution of blood-stasis, qi-depression and phlegm-wet were primary component of ER-/PR-breast cancer patients TCM constitution. The TCM constitution had no relation with prognosis. Blood-stasis was the main constitution of AR-positive case, the most constitution of AR-negative case was phlegm-wet. Blood-stasis and phlegm-wet may be the principal factors that affect the TCM constitution of ER-/PR-breast cancer patients. |
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