BACKGROUND Vitamin D has been suggested to prevent and improve the prognosis of several cancers, including breast cancer. We have previously shown a U-shaped association between pre-diagnostic serum levels of vitamin D and risk of breast cancer-related death, with poor survival in patients with the lowest and the highest levels respectively, as compared to the intermediate group. Vitamin D exerts its functions through the vitamin D receptor (VDR), and the aim of the current study was to investigate if the expression of VDR in invasive breast tumors is associated with breast cancer prognosis. METHODS VDR expression was evaluated in a tissue microarray of 718 invasive breast tumors. Covariation between VDR expression and established prognostic factors for breast cancer was analyzed, as well as associations between VDR expression and breast cancer mortality. RESULTS We found that positive VDR expression in the nuclei and cytoplasm of breast cancer cells was associated with favorable tumor characteristics such as smaller size, lower grade, estrogen receptor positivity and progesterone receptor positivity, and lower expression of Ki67. In addition, both intranuclear and cytoplasmic VDR expression were associated with a low risk of breast cancer mortality, hazard ratios 0.56 (95% CI 0.34-0.91) and 0.59 (0.30-1.16) respectively. CONCLUSIONS This study found that high expression of VDR in invasive breast tumors is associated with favorable prognostic factors and a low risk of breast cancer death. Hence, a high VDR expression is a positive prognostic factor.

中文翻译：

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浸润性乳腺肿瘤中的维生素D受体表达和乳腺癌生存率。

背景技术已经提出维生素D可预防和改善包括乳腺癌在内的几种癌症的预后。先前我们已经表明，维生素D的诊断前血清水平与乳腺癌相关的死亡风险之间呈U型关联，与中间组相比，最低和最高水平的患者生存率较差。维生素D通过维生素D受体（VDR）发挥其功能，本研究的目的是研究侵袭性乳腺肿瘤中VDR的表达是否与乳腺癌的预后相关。方法在718例浸润性乳腺肿瘤的组织芯片中评估VDR表达。分析了VDR表达与已建立的乳腺癌预后因素之间的协方差，以及VDR表达与乳腺癌死亡率之间的关联。结果我们发现乳腺癌细胞核和细胞质中的VDR阳性表达与良好的肿瘤特征有关，例如较小的肿瘤大小，较低的等级，雌激素受体阳性和孕激素受体阳性以及Ki67的较低表达。此外，核内和细胞质VDR表达均与乳腺癌死亡风险低相关，危险比分别为0.56（95％CI 0.34-0.91）和0.59（0.30-1.16）。结论本研究发现浸润性乳腺肿瘤中VDR的高表达与良好的预后因素和较低的乳腺癌死亡风险相关。因此，高VDR表达是一个积极的预后因素。结果我们发现乳腺癌细胞核和细胞质中的VDR阳性表达与良好的肿瘤特征有关，例如较小的肿瘤大小，较低的等级，雌激素受体阳性和孕激素受体阳性以及Ki67的较低表达。此外，核内和细胞质VDR表达均与乳腺癌死亡风险低相关，危险比分别为0.56（95％CI 0.34-0.91）和0.59（0.30-1.16）。结论本研究发现浸润性乳腺肿瘤中VDR的高表达与良好的预后因素和较低的乳腺癌死亡风险相关。因此，高VDR表达是一个积极的预后因素。结果我们发现乳腺癌细胞核和细胞质中的VDR阳性表达与良好的肿瘤特征有关，例如较小的肿瘤大小，较低的等级，雌激素受体阳性和孕激素受体阳性以及Ki67的较低表达。此外，核内和细胞质VDR表达均与乳腺癌死亡风险低相关，危险比分别为0.56（95％CI 0.34-0.91）和0.59（0.30-1.16）。结论本研究发现浸润性乳腺肿瘤中VDR的高表达与良好的预后因素和较低的乳腺癌死亡风险相关。因此，高VDR表达是一个积极的预后因素。雌激素受体阳性和孕激素受体阳性，并降低Ki67的表达。此外，核内和细胞质VDR表达均与乳腺癌死亡风险低相关，危险比分别为0.56（95％CI 0.34-0.91）和0.59（0.30-1.16）。结论本研究发现浸润性乳腺肿瘤中VDR的高表达与良好的预后因素和较低的乳腺癌死亡风险相关。因此，高VDR表达是一个积极的预后因素。雌激素受体阳性和孕激素受体阳性，并降低Ki67的表达。此外，核内和细胞质VDR表达均与乳腺癌死亡风险低相关，危险比分别为0.56（95％CI 0.34-0.91）和0.59（0.30-1.16）。结论本研究发现浸润性乳腺肿瘤中VDR的高表达与良好的预后因素和较低的乳腺癌死亡风险相关。因此，高VDR表达是一个积极的预后因素。结论本研究发现浸润性乳腺肿瘤中VDR的高表达与良好的预后因素和较低的乳腺癌死亡风险相关。因此，高VDR表达是一个积极的预后因素。结论本研究发现浸润性乳腺肿瘤中VDR的高表达与良好的预后因素和较低的乳腺癌死亡风险相关。因此，高VDR表达是一个积极的预后因素。