Detection Of PRL Levels In Nipple Discharge And Serum Of Patients With Breast Diseases

ObjectiveThrough the detection of PRL levels in nipple discharge,colostrum and serum,we hopes to preliminarily study the relationship between benign and malignant nipple discharge,colostrum PRL level,and the relationship between serum and nipple discharge PRL levels in patients with nipple discharge,so as to provide new research ideas for the occurrence and development of breast diseases accompanied by nipple discharge,which will be of great significance to the primary prevention,early diagnosis and treatment of these patientsAll samples were detected for PRL by sandwich electrochemiluminescence assay(ECLIA).and the data were analyzed by statistical method.In this study,all P values are bi-directional,and P values less than 0.05 are considered to be statistically significant.Materials and MethodsNipple discharge and corresponding serum samples were taken from patients who were treated in the Department of Breast surgery in Qilu Hospital of Shandong University from January 2018 to June 2019.After screening,nipple discharge and serum samples were obtained from 66 patients with nipple discharge,including 52 cases of benign breast diseases and 14 cases of breast cancerThe bilateral breast colostrum samples of 50 parturients in the Department of Obstetrics,Qilu Hospital of Shandong University from May 2018 to December 2018 were collected as healthy controls.The serum PRL levels of patients with breast diseases without nipple discharge were collected from January 2019 to December 2019 in the Department of Breast surgery of Qilu Hospital of Shandong University,including 133 cases of benign breast diseases and 144 cases of breast cancer.The level of PRL in all samples was detected by sandwich electrochemiluminescence assay(ECLIA),and the data were analyzed by statistical method.In this study,all P values are bi-directional,and P values less than 0.05 are considered to be statistically significant.ResultsThe first part Analysis of PRL levels in serum,nipple discharge and colostrum in patients with nipple discharge1.Analysis of serum PRL level in patients with nipple discharge:(1)The median level of PRL in serum samples of 66 patients with nipple discharge was 22.21ng/ml,and the quartile was 21.81ng/ml and 32.42ng/ml,respectively.The median level of PRL in serum samples of 52 patients with benign nipple discharge was 21.97ng/ml,and the quartiles were 13.84ng/m,21.97ng/m and 33.26ng/ml,respectively.The median level of PRL in serum samples of 14 patients with malignant nipple discharge was 13.28ng/ml,and the quartiles were 7.95ng/ml,13.28ng/ml and 28.2ng/ml,respectively.(2)There was no significant difference in serum PRL levels between benign and malignant nipple discharge patients by Mann-Whitney U test,(P>0.05).(3)43.94%(29/66)of the patients with nipple discharge were hyperprolactinemia,44.23%(23/52)of the patients with benign nipple discharge were hyperprolactinemia,and 42.86%(6/14)of the patients with malignant nipple discharge were hyperprolactinemia.(4)There was no significant difference in the incidence of hyperprolactinemia in patients with benign and malignant nipple discharge by chi-square test,P>0.05?2.Analysis of PRL detection level in nipple discharge(1)In 66 cases of nipple discharge,the median of PRL level was 26.20ng/ml,and the quartile was 15.35ng/ml,26.20ng/ml and 36.65ng/ml.In 52 cases of benign nipple discharge,the median of PRL level was 25.40ng/ml,and the quartile was 17.25ng/ml,25.40ng/ml and 43.35ng/ml.In 14 cases of malignant nipple discharge,the measured value of PRL level was normal distribution data,and the mean±standard deviation was 23.00±10.71ng/ml(2)There was no significant difference in the level of PRL between benign and malignant nipple discharge detected by two independent samples of Mann-Whitney,P>0.05.3.Correlation and difference of PRL detection level between nipple discharge and corresponding serum:(1)Spearman correlation analysis showed that there was a significant correlation between the level of PRL in nipple discharge and its corresponding serum,which was a positive correlation,r=0.534,P<0.05(2)Using the Wilcoxon symbolic rank sum test of paired data,there was a significant difference in the level of PRL between the nipple discharge and the corresponding serum.The level of PRL in the nipple discharge was significantly higher than that in the corresponding serum,P<0.054.Analysis of detection level of PRL in colostrum and difference of PRL detection level between nipple discharge and colostrum(1)There was no significant difference in PRL detection level between left and right colostrum specimens of 50 subjects.The average value of PRL detection level in bilateral colostrum samples was normal distribution data,and the mean±standard deviation was 68.80±39.00ng/ml.(2)There was a significant difference in the detection level of PRL between nipple discharge and colostrum samples by two independent samples of Mann-Whitney U test,P<0.05.The level of PRL in nipple discharge was lower than that in colostrum The second part Analysis of serum PRL levels in patients with breast diseases without nipple discharge1.26.32%(35/133)of the benign patients had hyperprolactinemia and 31.25%(45/144)of the malignant patients had hyperprolactinemia.2.There was no significant difference in the incidence of hyperprolactinemia between benign and malignant breast diseases by chi-square test,P>0.05.3.There was no significant difference in the level of PRL in serum samples of benign and malignant breast diseases detected by Mann-Whitney U test from two independent samples,P>0.05?The third part Difference of serum PRL levels between nipple discharge and non-nipple discharge patients with breast disease1.Difference of serum PRL levels in 66 patients with nipple discharge and 277 patients with breast disease without nipple discharge(1)The difference of serum PRL detection level between nipple discharge and non-nipple discharge breast disease patients was compared by two independent samples Mann-Whitney U test.There was significant difference in serum PRL detection level between the two groups,P<0.05,The level of PRL in serum of patients with breast disease with nipple discharge was significantly higher than that without nipple discharge.(2)Chi-square test was used to compare the incidence of hyperprolactinemia in patients with nipple discharge and non-nipple discharge.The results showed that the incidence of hyperprolactinemia in patients with nipple discharge breast disease was significantly higher than that in patients with non-nipple discharge breast disease,P<0.05.2.Difference of serum PRL levels in 14 breast cancer patients with nipple discharge and 144 breast cancer patients without nipple discharge(1)There was no significant difference in serum PRL levels between breast cancer patients with nipple discharge and breast cancer patients without nipple discharge by using two independent samples of Mann-Whitney U test,P>0.05(2)There was no significant difference in the incidence of hyperprolactinemia between breast cancer patients with nipple discharge and breast cancer patients without nipple discharge by chi-square test,P>0.05?3.Difference of serum PRL levels in 52 patients with nipple discharge and 133 patients with benign breast disease without nipple discharge(1)The levels of PRL in serum of patients with benign breast disease with nipple discharge and those without nipple discharge were compared by two independent samples Mann-Whitney U test.There was significant difference in serum PRL level between the two groups,P<0.05.The expression level of PRL in serum with nipple discharge group was significantly higher than that without nipple discharge group(2)Chi-square test was used to compare the incidence of hyperprolactinemia in patients with benign breast diseases between nipple discharge group and non-nipple discharge group.The results showed that the incidence of hyperprolactinemia in nipple discharge group was significantly higher than that in non-nipple discharge group,P<0.05Conclusions1.The level of PRL in nipple discharge is significantly higher than that in serum,suggesting that PRL is locally concentrated in the milk duct,and its specific mechanism needs further experimental study.2.The expression of PRL in nipple discharge and its corresponding serum samples was significantly correlated and positively correlated.PRL in nipple discharge may be affected by serum PRL3.The level of serum PRL in patients with nipple discharge is significantly higher than that in patients with breast disease without nipple discharge,suggesting that PRL may be related to the occurrence of nipple discharge disease4.There was no significant difference in PRL levels between serum and nipple discharge in patients with benign and malignant breast diseases.the role of detecting PRL levels in serum and nipple discharge in differentiating benign and malignant breast diseases needs to be further studied5.There is a high level of PRL,in colostrum and the level of PRL in colostrum is significantly higher than that in nipple discharge,suggesting that PRL may play different roles in physiological and pathological nipple discharge.