Correlation Analysis Of The Effects Of Androgen Receptor And Tumor Infiltrating Lymphocytes On The Prognosis Of Triple-negative Breast Cancer

Research background and purpose: The latest epidemiological survey shows that breast cancer is still the number one malignant tumor that threatens women’s health.Among them,TNBC is the type with a poor prognosis.At present,many studies have shown that the expression of AR in breast cancer and the degree of infiltration of TILs before treatment have a predictive effect on the prognosis of triple-negative breast cancer.Both may be independent risk factors affecting the prognosis of TNBC,and there is a correlation between the expression of androgen receptor and the degree of tumor lymphocyte infiltration.This study mainly discusses the expression characteristics of AR and TILs in TNBC,the correlation between the expressions of the two,and the correlation analysis between the effects of the two on the prognosis of TNBC.Methods:Collect the basic clinical data(including: age of onset,menstrual status,body weight)of triple-negative breast cancer patients who underwent surgical treatment at the first admission of patients with triple-negative breast cancer who were admitted to the hospital from January 1,2015 to December 31,2018 at Taizhou People’s Hospital Index),collect and statistics the basic pathological data of patients(including: primary tumor,regional lymphatic and distant metastasis,histological grade,presence or absence of nerve invasion,vascular tumor thrombus,Ki-67,epidermal growth factor receptor,EGFR),CK5/6,P53).Immunohistochemical staining method was used to detect the expression of androgen receptor in tumor tissues: when ≥1% of tumor cell nuclei are stained to different degrees,it is AR positive expression.Hematoxylin-eosin staining was used to detect the degree of TILs infiltration in triple-negative breast cancer tissues: when the degree of TILs infiltration is less than 10%,it is no or low infiltration,10% to 39% is medium infiltration,and when the infiltration level is ≥40%,it is High infiltration.The total number of patients included in the statistics is 118,with complete case data,postoperative pathology and postoperative follow-up information.118 patients were followed up by telephone to follow up their health status and whether local recurrence or distant metastasis occurred.The follow-up end point was the occurrence of recurrence or metastasis on December 31,2021.Chi-square test and non-parametric test were used to compare between groups to analyze the characteristics of AR expression in TNBC and the characteristics of TILs infiltration.Spearman rank correlation was used to analyze the correlation between AR expression and TILs infiltration degree;univariate survival analysis and multivariate survival analysis were used to detect the influence of AR expression and TILs infiltration degree on the prognosis of TNBC patients.Results: A total of 118 TNBC patients were enrolled,and the average age of onset was 56.2(±11.8)years.Among them,62 cases(52.5%)were AR-positive breast cancer,and 56 cases(47.5%)were negative.Among the 118 patients,29 cases(24.6%)had no or low infiltration of TILs,47 cases(39.8%)with moderate infiltration,and 42 cases(35.6%)with high infiltration.The expression of AR in TNBC is significantly different in the age of onset of patients,whether there is vascular tumor thrombus,and whether recurrence and metastasis occurs(all P<0.05);the degree of TILs infiltration is in tumor recurrence and metastasis,whether there is vascular tumor thrombus,CK5/6 There was a significant difference in the expression of(all P<0.05).In patients with low TILs infiltration,27 cases were AR positive and 2 cases were negative;34 cases were positive for AR and 13 cases were negative for moderate infiltration;1 case was positive for AR and 41 cases were negative for high infiltration.The degree of TILs infiltration was obtained by Spearman rank correlation analysis.There is a correlation with the expression of AR(P=0.001,r=-0.719),and there is a negative correlation between the two.The results of univariate survival analysis showed that AR expression,TILs infiltration degree,histological grade,EGFR expression and vascular tumor thrombus in TNBC patients have an impact on DFS(Disease-free survival)(all P<0.01);The expression of AR and the degree of TILs infiltration have certain predictive value for the prognosis of TNBC patients.The results of multivariate survival analysis suggest that the degree of TILs infiltration,histological grade and the presence of vascular tumor thrombi have an impact on the prognosis of TNBC(P<0.05),and are independent risk factors affecting the prognosis of TNBC.The lower the degree of TILs infiltration,the more tissue The higher the academic grade and the presence of vascular tumor thrombi,the higher the tumor recurrence and metastasis rate of TNBC patients,and the worse the prognosis.Conclusion: AR has a high expression rate in triple-negative breast cancer patients who are older than 50 years old,have vascular tumor thrombi,and have recurrence and metastasis.When TILs have recurrence and metastasis,there are vascular tumor thrombi,and CK5/6 expression is negative,the degree of tumor invasion is lower.The expression of AR in TNBC is negatively correlated with the degree of infiltration of TILs.The higher the expression rate of AR,the lower the degree of infiltration of TILs.TILs,histological grades and vascular tumor thrombi have a certain predictive effect on the occurrence of recurrence and metastasis of triple-negative breast cancer,and they are independent factors affecting the prognosis.The degree of TILs infiltration is negatively correlated with the rate of recurrence and metastasis of TNBC.The higher the degree of TILs infiltration,the lower the possibility of recurrence and metastasis.