To Investigate The Expression And Significance Of CD4+,CD8+T Cells,TNF-α And Receptor P55 In Different Types Of Granulomatous Mastitis

Objective: To collect cases of granulomatous mastitis with different TCM syndromes.Immunohistochemical technique was used to detect the expression of CD4+,CD8+,TNF-α and its receptor p55 in different GLM syndromes,and to explore the possible relationship between the development of GLM and various inflammatory cells and cytokines.To further explore the pathogenesis of granulomatous mastitis and provide a theoretical basis for guiding treatment.Methods:From January 2017 to December 2018,patients with granulomatous mastitis who underwent surgery in the Affiliated Hospital of Shandong University of Traditional Chinese Medicine were divided into five groups according to TCM syndromes: liver depression and phlegm coagulation syndrome(mass stage)(15 cases),fever and incandescence syndrome(abscess stage)(18cases),Positive deficiency syndrome(late ulceration stage)(17 cases),immunohistochemistry.Methods CD4+,CD8+T lymphocyte,TNF-α and receptor P55 were detected in pathological tissues.The expression and significance of various indicators in different syndromes of granulomatous mastitis were analyzed.Results:1.The expression of CD4+T cells in liver depression and phlegmcoagulation syndrome(mass stage)and heat toxicity and incandescence syndrome(abscess stage)was higher than that in Positive deficiency syndrome(late ulcer stage)(P < 0.05).The difference was statistically significant.The expression of CD4+T cells in liver depression and phlegm coagulation syndrome(mass stage)was higher than that in heat toxicity and incandescence syndrome(abscess stage),and the difference was not statistically significant(P > 0.05);2.The expression of CD8+T cells in Positive deficiency syndrome(late ulcer Syndrome(mass stage)and heat toxicity incandescence syndrome(abscess stage)(P < 0.05),the difference was statistically significant,in heat toxicity incandescence syndrome(abscess stage)was higher than liver depression and phlegm coagulation syndrome(mass stage),the expression was not statistically significant(P >0.05).3.The expressions of TNF-α and P55 in different syndromes of granulomatous mastitis were liver depression and phlegm coagulation syndrome(mass stage)> heat toxicity and incandescence syndrome(abscess stage)>Positive deficiency syndrome(late ulcer stage)(P < 0.05),with statistical significance;4.The expressions of CD4 and CD8 + T cells in different syndromes of granulomatous mastitis were negatively correlated,with statistical significance,and CD8 + T cells increased with the expression of CD4 + T cells.5.The expression of TNF-α and P55 in granulomatous mastitis of different syndromes was positively correlated,with statistical significance.With the decrease of TNF-α expression,the expression of P55decreased;6.The expression of TNF-α was positively correlated with the expression of CD4+T cells,and negatively correlated with the expression of CD8+T cells,The difference was statistically significant.Conclusion: Granulomatous mastitis is an autoimmune response mediated by T cells.In the early stage of the disease,CD4 + T cells are highly expressed,CD8 + T cells are low expressed,CD4 + T cells are decreasing,CD8 + T cells are increasing,CD4 + T cells are negatively correlated with CD8 + T cells,T cell subsets are unbalanced,immune status is disordered,and the body has strong immune response,damage.Damage to breast tissue leads to delayed inflammation.The level of TNF-α and its receptor P55 decreased with the progress of the disease,which was negatively correlated with the progress of the disease.There was a positive correlation between TNF-α and receptor P55.The expression of TNF-α was positively correlated with the expression of CD4+T cells and negatively correlated with the expression of CD8+T cells,which provided different therapeutic ideas for the diagnosis and treatment of granulomatous mastitis.