浆细胞性乳腺炎：病因进展和未来方向的综合综述
Plasma cell mastitis: a comprehensive review of etiological advances and future directions.
摘要(中文译文)
浆细胞性乳腺炎（PCM）是一种复杂且难治的慢性炎性乳腺疾病，仍是全球女性健康领域的重大挑战。过去十年间，尽管在理解PCM的临床和病理特征方面取得了 considerable 进展，但PCM的确切病因在临床上仍具挑战性，因为该病的发病机制涉及多种因素。本叙述性综述系统综合了当前关于PCM的证据，主要聚焦于其病因学、临床表现、诊断和治疗策略，旨在从导管微生态到全身自身免疫揭示PCM的病因学图景。我们全面阐述了PCM的病因，包括解剖因素、免疫因素、微生物感染及其他因素。在解剖学上，乳头内陷和导管结构异常导致导管阻塞-扩张-破裂-间质炎症的病理链条；在免疫学上，白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）和白细胞介素-17（IL-17）等促炎因子显著升高，辅助性T细胞1（Th1）/Th17细胞过度活化，支持PCM可能是一种免疫介导疾病的可能；微生物因素的作用存在争议，大多数培养为无菌，少数与厌氧菌或分枝杆菌相关；吸烟和肥胖通过激素紊乱和慢性炎症参与发病机制。本综述还提供了PCM的诊断标准和鉴别诊断要点，并总结了目前主要以糖皮质激素和手术为主的治疗策略。未来研究需要建立可靠的动物模型并开展多组学研究，以揭示完整的因果链条。
Abstract
Plasma cell mastitis (PCM), a complex and refractory chronic inflammatory-like breast disease, remains a critical global female healthcare challenge. Over the past decade, although considerable effects have been gained on understanding of the clinical and pathological features of PCM, the exact cause of PCM remains clinically challenging, as the pathogenesis of this disease involves multiple factors. This narrative review systematically synthesizes current evidence on PCM, mainly focusing on its etiology, clinical manifestations, diagnosis, and treatment strategies, which aims to unravel the etiological landscape of PCM from ductal microecology to systemic autoimmunity. We comprehensively demonstrated the etiology of PCM including the anatomical factors, immunological factors, microbial infections, and other factors. Anatomically, inverted nipples and duct structural abnormalities lead to a pathological chain of ductal obstruction - dilation - rupture - stromal inflammation; Immunologically, pro-inflammatory factors such as interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-17 (IL-17) are significantly elevated, and helper T cell 1 (Th1)/Th17 cells are overly activated, supporting the possibility that PCM may be an immune-mediated disease; The role of microbial factors is controversial, with most cultures being sterile and a few associated with anaerobic bacteria or mycobacteria; Smoking and obesity are involved in the pathogenesis through hormonal disorders and chronic inflammation. This review also provides diagnostic criteria and key points for differential diagnosis of PCM, and summarizes the current treatment strategies mainly based on glucocorticoids and surgery. Future research needs to establish reliable animal models and conduct multi-omics studies to reveal the complete causal chain.
如何引用
AMA
Hong Xu, Buxilite Da, Yuanqing Li, Hao Zheng, Lihua Xue, Fengxia Zhao, et al. Plasma cell mastitis: a comprehensive review of etiological advances and future directions.. Frontiers in immunology. 2026; doi:10.3389/fimmu.2026.1726988.
APA
Hong Xu, Buxilite Da, Yuanqing Li, Hao Zheng, Lihua Xue, Fengxia Zhao, et al (2026). Plasma cell mastitis: a comprehensive review of etiological advances and future directions.. Frontiers in immunology. https://doi.org/10.3389/fimmu.2026.1726988
GB/T 7714
Hong Xu, Buxilite Da, Yuanqing Li, Hao Zheng, Lihua Xue, Fengxia Zhao, et al. Plasma cell mastitis: a comprehensive review of etiological advances and future directions.[J]. Frontiers in immunology, 2026 doi:10.3389/fimmu.2026.1726988.
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