The Expression And Meaning Of CD68,CD163,CD57,IgG4 In Granulomatous Lobular Mastitis,GLM

【Objective】Granulomatous Mastitis, also known as Granulomatous Lobular Mastitis,Granulomatous Mastitis pseudotumor after lactation,Idiopathic Granulomatous Mastitis. So far, the exact etiology and pathogenesis of the disease is not clear, the pathological diagnosis is the gold standard for the diagnosis, so its treatment also is varied, there is no unified curative effect evaluation index. Granulomatous Lobular Mastitis is a immune-related diseases in present mainstream view. many kinds of inflammatory cells and the cytokines involved in the occurrence and development of the disease process. This experiment aims to investigates the expression of CD68, CD163 positive M1, M2 Macrophages, CD57 positive natural killer cells, IgG4 positive CD57 positive plasma cells in the tissue of Granulomatous Lobular Mastitis lesion, analysis the relationship between the expression of CD68, CD163 positive M2 macrophages, CD57 positive natural killer cells, IgG4 positive CD57 positive plasma cells and clinical pathologic features of patients with Granulomatous Lobular Mastitis, to explore the correlation with the occurrence,development and outcome.【Methods】Collected the surgical pathologic specimens of Granulomatous Lobular Mastitis of Hunan Provincial People’s Hospital admitted in between2012.10 to 2015.10.Depending on the postoperative pathological diagnosis, set the experimental group and two control group.Experimental group is GLM, 36 cases; Control group 1 for PCM,17 cases; The control group 2 for breast cystic hyperplasia,10 cases; detected M2 macrophages,NK cells, the expression of IgG4 positive plasma cells in three groups.We archive the paraffin samples from cases above, serial section,and then immunohistochemical staining with Eli Vision super testing each corresponding antigen expression in patients with pathological tissue.Comparing the relationship of the expression with its duration, age stratification, reproductive condition, nipple retraction and the size of the lump related clinical parameters,and then analysis the express of three groups of immune cells with clinical parameters.【Result】1.The detection index is different in the experimental group and control group, there is no positive expression in the cystic hyperplasia.(1)positive expression rate of CD68, and CD163 in the GLM group,respectively, 88.88%, 91.67%, with strong positive expression rate:27.77%, 11.11%; In PCM: the positive expression rate of 94.12%, 100%,with strong positive expression rate: 35.29%, 29.41%;(2) positive expression rate of CD57 in the GLM group :63.88%, 82.35% in the PCM,with strong positive expression rate: 2.77% in the GLM group,11.76%in the PCM group;(3) the positive expression rate of IgG4 in GLM group is 30.56%, 23.53%in the PCM group, the positive expression were weakly positive.2.There is no significant difference between the expressions of the index in the GLM or PCM, But the three were higher than in breast cystic hyperplasia group, P < 0.05, statistically significant;3.There is no obvious difference at the different stages(2 weeks,2weeks or less-more than 3 months) of CD68, CD163 and IgG4 for GLM and PCM, the three indicators above do not changes significantly over the course of the disease(P 0.05 or higher); The expression of CD57 in 2 ~ 3months is significantly higher than 2 weeks or less for Granulomatous lobular mastitis,P < 0.05,statistically significant.The expression of CD57 do not changes over course in plasma cell mastitis, P 0.05 or higher;4.The expression of CD68, CD163, CD57 and IgG4 is all the same in the baby boom(25 to 34 years old) or away the baby boom(21-24, 35 to 55 years old) for GM and PCM,no significant statistical difference, P0.05 or higher.5.There is no obvious difference of the expression of CD68,CD163 and IgG4 between patients within 2 years after childbirth or more than 2 years for GLM and PCM.p 0.05 or higher; the expression of CD68 were significantly higher than those patients within 2 years after lactation for PCM,statistically significant,P < 0.05.6.There is no obvious difference of the expression of CD68,CD163 and CD57 in patients with nipple retraction or not for GLM and PCM.p 0.05 or higher; the expression of IgG4 in nipple retraction was obviously higher than patients not,P < 0.05,statistically significant.7.There is no obvious difference in the expression of CD68,CD163 and IgG4 with different tumor diameter(less 3 cm, 3-6 cm, 6 cm or higher)for GLM and PCM, the indicators above do not changes significantly over lump size(P 0.05 or higher).【Conclusion】1.GLM and PCM have M2 macrophages, NK cells, IgG4 infiltration,confirmed that inflammatory cells involved in the occurrence of the disease.2.The expression of CD57 of GM in the course of 2 weeks to 3months is significantly higher than 2 weeks ago, Speculating that natural killer cells be the important basis of GLM clinical staging.The expression of CD57 in Plasma Cell Mastitis of patients sick more than 2 years after childbirth is higher than 2 years ago,Speculating that Plasma Cell Mastitis may related to Pregnancy or lactation.3.The expression of IgG4 in patients with nipple retraction is higher than the patients without nipple retraction in Granulomatous Mastitis but they were low expression.Speculating that they were different clinical subtypes of granulomatous mastitis.