Bacteriological Study Of Mammary Duct Ectasia

BackgroundAthough the incidence rate of mammary duct ectasia stands for5%in all the benign breast diseases, the etiology of this disease is still unclear. Since the very first report of this disease, domestic and foreign scholars had proposed many hypotheses:endogenous or exogenous factors cause nipple abnormalities mechanical in the milk ducts; poor drainage and secretions siltation result in aseptic inflammation; at the same time some scholars believe that the disease is caused by hormonal imbalance. However, the more recent literatures consider the disease has business with bacterial infection (especially anaerobic bacteria and Mycobactcrium infection) and smoking.Professor Wang Qi publicated the paper Identification and treatment of periductal mastitis and granulomatous mastitis. In his article he applyed classic anti-TB drugs (isoniazid, rifampicin, ethambutol) to cure mammary ductal dilatation patients. He pioneered the use of anti-tuberculosis drugs in the treatment of this disease is because referencing the2002Chinese Medical Association Tuberculosis Branch diagnostic criteria:after long-term healing to extrapulmonary soft tissues without cure should consider NTM (nontuberculosis mycobacteria tuberculosis) infection. Although drug testing is sufficient to prove that the anti-tuberculosis treatment is effective, but unfortunately, Professor Wang Qi has been unable to detect or culture Mycobacterium tuberculosis or Mycobacterium tuberculosis.Dixon Professor, as a famous scholar, insisted that the bacterial infection is an important factor of mammary duct ectasia. Following, some scholars culture tissues of duct ectasia and found that the main pathogenic is anaerobic bacteria, including enterococci, anaerobic streptococci, Staphylococcus aureus. However, some can not culture bacteria, which drops us into deep thinking of the real bacteria.PurposeThis study intends to use the Mycobacterium tuberculosis culture, real-time quantitative PCR method to detect mycobacterium tuberculosis,and use PCR16srDNA universal primers and sequenced to compared with bacterial sequence further clear ductal ectasia bacteriological etiology.Participants and methodsIn the Mycobacterium tuberculosis detection group, we collected the pus or/and tissue samples from5females duct ectasia with abscesses patients under sterile conditions. All the samples are collected within half an hour of the in vitro environment,then stored at-20℃until detection.In the PCR16srDNA primers experimental group, we selected11patients during the period from2007.10to2011.10adding the above5patients.Collecting samples as the Mycobacterium tuberculosis detection group.The16cases in the study group were1:3paired with patients form the data base of benign breast disease patients according to age(±2years),treatment time(±1), The screened15patients were enrolled as the control group. All of the patients did not get any chemotherapy, radiotherapy or endocrine therapy before enrolled in this study. We surveyed all the patient’s age, marriage year, age at menarche, menstrual, menstrual cycle, breast-feeding time, number of births, smoking, passive smoking, Nipple retraction conditions. All data were analyzed by SPSS16.0statistical software.After pretreatment of the specimen group one culture Mycobacterium tuberculosis all together eight weeks, three times a week to observe. Mycobacterium tuberculosis PCR group experience DNA extraction, amplification then detection by the Lightcycler480PCR apparatus.16srDNA primer PCR Group:after designing bacteria16srDNA universal primers, we applied agarose gel electrophoresis.Then PCR reaction production would be measured sequence with blast to clear the types of bacteria. ResultsAfter8weeks to observe, we could not discover the growth of Mycobacterium tuberculosis; the result of PCR group is still negnative:lightcyler480instrument tray window displays the growth curve is not S-shaped, and the Ct value=30.In16srDNA experimental group, each group had found bacteria:Pseudomonas (50%), Staphylococcus aureus (6.25%), Sporosarcina newyorkensis (6.25%), Bacillus firmus strain (6.25%), Enterococcus faecium (6.25%), Uncultured bacterium clone (25%).After McNemarx2Test statistical analysis, inverted nipple (P=0.001) and second-hand smoke (p=0.009) owned a statistically significant between the study group and the control group, but no significant difference in Logistic regression analysis.ConclusionIn this study, we could preliminary determine the mammary duct ectasia hardly has correction with Mycobacterium tuberculosis but great correction with other bacteria (such as:Pseudomonas).But the relationship between bacterial infection and mammary duct ectasia yet to be explored. Inverted nipple and second-hand smoke condition maybe have relationship with mammary duct ectasia.