Identification Of Expression Of Androgen Receptor And Prognosis In Breast Cancer

Objective:Currently,the breast carcinoma has been the most common malignant tumor in female.breast cancer is a hormone dependent and highly heterogeneity disease.Estrogen receptor and progesterone receptor as independent risk factors of breast cancer is well known in the occurrence and development of breast cancer.Recently,a lot of researches identified that the abnormal expression of AR(androgen receptor)in breast cancer had close association with clinical pathological characteristics and prognosis of breast cancer.However,the exact mechanism of relationship of AR expression level in breast cancer and prognosis is still unclear.Different detection method and objective technology may be a reasonable explanation of the differences in results world wild.So,In this study,The data of breast cancer in the breast cancer center of the Fourth Hospital of Hebei Medical University(China)in 2008 was rearranged and all the patients were followed up.According to the newest international diagnostic criteria,pathological section of all patients were read again to find out the expression level of different breast cancer immunohistochemical markers.According to the results,breast cancer was divided into four different molecular subtypes to discuss the relationship between expression of AR and prognosis.In this study,the results may provide a new thought in the treatment of breast cancer.Methods:There are female patients whose pathological data of primary breast cancer went surgery from January 2008 to December 2008.According to selection criteria of this study,637 patients are qualified.Pathological data was selected in detail and all enrolled patients were followed up at least one time by outpatient review or telephone.Beginning of follow-up is the date when breast cancer was diagnosed and the endpoint of follow-up was June 2015.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,all the routine pathological sections and immunohistochemistry sections were reread to classify different molecular classification.Follow up data,molecular classification and different AR expression level in different molecular subtypes and the relationship between AR expression level and prognosis of breast cancer were discussed.Results:1 The expression of ARAR expression positive ratio accounting for 77.7% in female patients of breast cancer.2 Relationship between AR and molecular subtypesAR expression has statistical difference among 4 different molecular subtypes.(?2=66.215,P< 0.001).There has no statistical difference between Luminal-A and Luminal-B on AR expression(?2=1.27 P=0.259>0.05).There is also no statistical difference between HER2 positive and triple negative on AR expression(?2=0.54,P=0.464>0.05).Statistical difference on AR expression exists in other molecular subtypes(P<0.001),AR is less expressed in Luminal-A and Luminal-B subtype than that in HER2 positive and triple negative subtypes.3 The expression of AR and DFS,OSOS and DFS has no statistical difference between AR positive and AR negative patients(P>0.05).In each molecular subtypes,OS also has no statistical difference between AR positive and AR negative patients(every P>0.05).There is no statistical difference on DFS between AR positive and AR negative patients(P>0.05).DFS has statistical difference between AR positive and AR negative patientsin Luminal-A subtype breast cancer.DFS has no statistical difference in other molecular subtypes(every P>0.05).4 AR and prognosisMake 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.5 Tumor staging and PrognosisDFS and OS of 637 patients' was analyzed according to AR expression AR expression,molecular subtypes,age,menstrual status,tumor size,lymph node metastasis,histological grade by Cox univariate analysis.The results showed that DFS and OS of surgery patients was significantly effected by the number of metastasis lymph nodes.It is showed that number of positive metastases lymph nodes is an independent influence factors on DFS and OS(P< 0.05).Conclusion:1 AR positive in female patients accounted of most in the early breast cancer.2 The expression of AR was statistically difference in 4 different molecular subtypes.AR is less expressed in Luminal-A and Luminal-B subtype than that in HER2 positive and triple negative subtypes.3 There has no relationship between AR and DFS and OS in early breast cancer.It could not be proved that AR is a good indicator for the prognosis of breast cancer.