乳腺慢性炎症是一种临床上较少见的乳腺炎性疾病,又称非哺乳期乳腺炎,近几年发病率有明显上升趋势。但由于临床医生对该病认识不足,且病因不明,从而导致目前对该病的检出率低,治愈率低。目前认为非哺乳期乳腺炎是一个免疫相关性疾病,有多种细胞及细胞因子参与疾病的发生、发展过程。各类细胞因子在非哺乳期乳腺炎的疾病进展的不同阶段,其血浆含量不同,并有一定规律。本文就肿瘤坏死因子-α,NK细胞,干扰素-γ,CD4+T细胞亚群,树突状细胞及趋化因子与非哺乳期乳腺炎之间的关系进行综述。

Chronic inflammation of the mammary gland ,also known as non -lactating mastitis, is a rare kind of clinical mastitis disease ,the incidence of which is on the rise in recent years .Due to the cause is unknown , the detected rate and cure rate are at low levels .Now think of nonpuerperal mastitis is a related immune diseases , has a variety of cells and cyto-kines involved in the occurrence and development of disease process .All kinds of cytokines in nonpuerperal mastitis of the various stages of disease progression , different levels of plasma , and has certain regularity .In this paper , the tumor necrosis factor alpha, NK cells, interferon-gamma, CD4 +T cells, dendritic cells and chemokines , and summarized the relation-ship between nonpuerperal mastitis .

目的探讨应用麦默通微创旋切术加置管引流治疗乳腺炎性疾病的临床疗效。方法回顾性分析郑州大学附属郑州中心医院乳甲外科2009年6月至2012年12月收治的95例超声及临床检查诊断为急、慢性乳腺炎伴脓肿形成的女性患者的临床资料,所有患者均于炎症局限后在超声引导下行乳腺炎性病灶麦默通微创旋切术加置管引流治疗。结果 95例患者均采用麦默通微创旋切术加置管引流,超声均能清晰显示微创旋切病灶及脓液抽吸过程,术后置管引流约5~7 d,治愈率为97.9%(93/95)。其中4例患者术后出现少量皮下淤血,平均7~14 d后缓慢自行吸收。术后3、6个月分别复查超声,均提示切除完全,愈合良好;2例合并浆细胞性乳腺炎的患者分别于术后13、15个月复发,复发率为2.1%(2/95),再次行开放性手术后治愈。其中3例涉及2个以上象限的巨大脓肿经本方法治疗,术后置管引流7 d,均愈合良好,随访未见复发。95例患者的脓液标本均经细菌培养,阳性率为70.5%(67/95);切除标本病理结果均为乳腺炎性病变。结论超声引导下麦默通微创旋切术加置管引流治疗急、慢性哺乳期及非哺乳期乳腺炎伴脓肿形成的患者,其疗效均可靠,值得临床推广。

Objective To investigate the clinical efficacy of vaccum-assisted mammotome minimally invasive system plus catheter drainage in the treatment of mastitis. Methods We retrospectively analyzed 95 females with acute or chronic mastitis plus abscess confirmed by ultrasound and clinical examination in our Department of Breast and Thyroid Surgery, Zhengzhou Central Hospital Affiliated to Zhengzhou University from June 2009 to December 2012. For all the patients, the lesions of mastitis were excised by mammotome minimally invasive system under the guidance of ultrasound, and then the drainage was applied. Results The ultrasonography clearly demonstrated the procedure of lesion excision and abscess aspiration. The catheter drainage was maintained for about 5 to 7 days after operation. Four patients had slight subcutaneous congestion, which was self-absorbed slowly 7 to 14 days later. The ultrasound reexamination at postoperative 3 and 6 months showed that all the lesions were completely resect

目的 探讨乳腺癌磁共振成像（MRI）漏诊和误诊病例的临床、影像和病理学改变可能的原因.方法 回顾总结术前行乳腺MRI、超声和X线检查患者121例临床资料,经穿刺或手术病理证实为乳腺良、恶性病变共241个,采用BL-RADS分类,分析其影像学表现,并进行最终评估.由外科、影像科和病理科医生共同分析MRI误诊和漏诊病例的可能原因、病理学基础.结果 241个乳腺病变中恶性120个、良性121个.MRI漏诊4个,分别为导管内乳头状瘤病2个、纤维腺瘤2个,均为良性.MRI误诊23个,其中高估16个,高估的病变包括慢性乳腺炎3个、硬化性腺病各3个,纤维腺瘤、结节腺病伴重度非典型增生、导管内乳头状瘤、乳腺腺病各2个,乳腺癌胸肌侵犯、乳腺癌腋窝淋巴结转移各1个;低估7个,包括浸润性导管癌2个、黏液癌1个、乳腺原位癌2个、盲管腺病伴重度非典型增生局灶恶变1个、炎性乳腺癌化疗后1个. MRI诊断乳腺癌的敏感度为95.83％（115/120）,特异度为72.73％（88/121）,诊断准确率为84.23％（203/241）.乳腺MRI发现病变与乳腺超声或X线形态或临床检查的符合率为75.10％（181/241）.结论 MRI误诊和漏诊常发生于乳腺病灶较小、形态学和血流动力学恶性表现不典型者,特别是导管内病变.应结合体检、乳腺X线和超声检查以提高诊断准确度、减少漏诊.

Objective To analyze the MRI data of misdiagnosed and missed diagnosed of breast lesions and their histopathological features.Methods Data from 241 breast lesions within 121 patients were recruited in this study.The data included MRI images,uhrasounds and X-ray images were retrospectively interpreted by two radiologist and each lesion was assessed according to the BI-RADS classification.The pathologic features of miss or error diagnosed lesions on MRI were analyzed.Results In 241 breast lesions (malignance 120,bcnign 121),4 lcsions were miss diagnosed on MRI.Thcy were 2 intraductal papillomatosis and 2 fibroadenoma.All was benign.Twenty three lesions were misdiagnosed on MRI.Sixteen were overestimation,including 3 chronic inflammations,3 sclerosing adenosis,2 fibroadenoma,4 fibrocystic changes with or without atypical ductal hyperplasia (ADH),2 intraductal papilloma,1 infiltration of pectoralis major muscle and 1 axillary lymphnode metastasis.Meanwhile,there were 7 lesions were underes