Expression Of Androgen Receptor In Triple-negative Breast Cancer And Its Prognostic Significance

Background and Objective:Triple-negative breast cancer is highly heterogeneous and invasive.Due to the negative expression of ER,PR and Her-2,there is currently no effective therapeutic target.Therefore,it is completely important and necessary to find new prognostic indicators and therapeutic targets.In recent years,many studies have shown that androgen receptor(AR)has a proportion of expression in triple-negative breast cancer,and Lehmann 's analysis of gene expression profiles in triple-negative breast cancer patients also supports this conclusion.And these triple-negative breast cancer patients with positive androgen receptor expression were classified into luminal androgen receptor type(LAR).In previous studies,AR showed significant correlation with clinical pathological features and prognosis of tumors,but the results of different studies were quite different.The relationship between AR expression and clinicopathological features and prognosis of triple-negative breast cancer is still unclear.Relevant research data in Chinese population is pretty rare.Based on this background,this paper aims to investigate the expression of androgen receptor in Chinese triple-negative breast cancer patients,and analyze the correlation between its expression and tumor size,histological grade,Ki-67 and other clinicopathological features.Patient survival is analyzed to reveal its prognostic value.Methods:We collected the clinical data of 133 female patients with triple-negative breast cancer in the Tumor Hospital Affiliated to Zhengzhou University from January,2014 to October,2015.These 133 patients did not receive neoadjuvant chemotherapy and did not have distant metastasis.The expression of AR in breast cancer tissues was detected by immunohistochemical staining.We analyzed the relationship of AR expression with the other clinicopathological characteristics and survival.Correlation analysis between AR expression and clinicopathological characteristics were analyzed using Chi-square or fisher's exact text.Survival analysis was performed according to Kaplan-Meier method.Log-rank statistics was used to compare the subgroups.Multivariate analysis were performed using Cox proportional hazard regression model.Results:There are total 38 AR positive patients in 133 triple-negative breast cancer patients.The positive rate of AR expression was 28.6%(38/133).AR expression were significantly related to the elder age(?50years old),menopause,lower Ki-67 index and negative CK5/6(p<0.05).There is no significant relationship between AR expression and menarche age,BMI,diabetes,family history of malignant tumor,histological grade,lymph node status,vascular invasion,TNM stage and EGFR(p> 0.05).Univariate analysis of survival analysis showed that the overall survival of AR-positive group was better than that of AR-negative group(p<0.05);BMI<28 group and EGFR-positive group had better disease-free survival(p<0.05).Multivariate Cox proportional hazard regression analysis showed that BMI and EGFR were independent influence factors of disease-free survival in patients with triple-negative breast cancer(p<0.05);however,there was no correlation between AR-positive and disease-free survival and overall survival(p>0.05).Conclusion:1.The AR positive rate of triple-negative breast cancer patients in this study was 28.6%.2.The triple-negative breast cancer patients with elder age(?50 years),menopause,low Ki-67 index(?14%)and negative CK5/6 have higher AR positive rates.3.In the univariate analysis of survival analysis,AR-positive triple-negative breast cancer patients had better OS,but multivariate Cox proportional hazard regression analysis failed to demonstrate that AR is an independent prognostic factor for DFS and OS.