肉芽肿性小叶性乳腺炎的病因和治疗研究新进展

New Research Progress on the Etiology and Treatment of Granulomatous Lobular Mastitis

摘要: 肉芽肿性小叶性乳腺炎(Granulomatous lobular mastitis, GLM)是局限于乳腺小叶、形成肉芽肿为主要特征的乳腺慢性炎症性疾病，是一种非细菌感染性炎症。该病虽为良性疾病，却可造成乳房千疮百孔，甚至丧失乳房，被称为“良性疾病中的乳癌”。成为继乳腺恶性肿瘤之后对育龄期妇女身心威胁最大的非哺乳期乳腺炎症疾病。GLM的病因迄今仍不完全清楚，目前多认为自身免疫所致炎症反应、感染因素、基因多态性与基因突变等可能导致GLM的发生，另外诱发GLM的因素还包括长期吸烟、哺乳障碍或乳汁淤积、乳房钝性外伤、口服避孕药或精神类药物、高泌乳素血症等。本篇将围绕GLM的病因和治疗新进展进行综述。

Abstract: Granulomatous lobular mastitis (GLM) is a chronic inflammatory disease of the breast that is limited to the breast lobules and characterized by the formation of granulomas. It is a non-bacterial infectious inflammation. Although the disease is a benign disease, it can cause many holes in the breast and even loss of the breast, which is called “breast cancer among benign diseases”. It has become the non-lactation breast inflammatory disease that poses the greatest physical and psy-chological threat to women of childbearing age after breast cancer. The etiology of GLM is still not fully understood. At present, it is believed that inflammation caused by autoimmunity, infectious factors, gene polymorphisms and gene mutations may lead to the occurrence of GLM. In addition, the factors that induce GLM also include long-term smoking, lactation disorders or breast milk, stasis, blunt breast trauma, oral contraceptives or psychotropic drugs, hyperprolactinemia, etc. This article will review the new progress in the etiology and treatment.