Wu Ruiyang, Zhang Haiyan, Wang Yan, Mo Yunlu, Hu Huihua, Chen Jin, Huang Wei, Shi Qinyan, Kang Yuqing, Luo Jing
Department of Breast and Thyroid, Sichuan Provincial Hospital for Women and Children (Affiliated Women and Children's Hospital of Chengdu Medical College), Chengdu, China.
Department of Pathology, Sichuan Provincial Hospital for Women and Children (Affiliated Women and Children's Hospital of Chengdu Medical College), Chengdu, China.
PLoS One. 2025 Mar 19;20(3):e0319956. doi: 10.1371/journal.pone.0319956. eCollection 2025.
The prognosis of granulomatous lobular mastitis (GLM) had been poor, primarily due to the lack of a unified disease assessment standard.
The purpose of this cohort study was to establish a staging system for GLM to more accurately evaluate the prognosis of patients.
This study retrospectively collected data from 264 GLM patients who visited our hospital between January 2017 and December 2023. Through logistic regression analysis, factors associated with prognosis were identified, which served as the basis for creating a new staging system.
Univariate and multivariate logistic regression analysis revealed that hyperlipidemia (HR: 2.031; 95% CI: 1.100-3.750) and microabscesses (HR: 2.087; 95% CI = 1.138-3.827) were significant independent risk factors affecting the prognosis of GLM patients. Based on the results of logistic analysis, three different stages were ultimately established, and it was found that stage C had the highest AUC value (AUC: 0.642), followed by stage B (AUC: 0.628), with stage A (AUC: 0.614) having the lowest. The Delong test revealed no significant difference in AUC values between stage A and stage B (P = 0.255), nor between stage B and stage C (P = 0.263). However, the AUC value of the stage C was found to be higher than that of stage A (P < 0.001). Given that stage C has the highest AUC value, this study selected stage C as the final stage for evaluating the prognosis of GLM patients and named it the 1st edition of GLM stage.
This study constructed a rigorous and widely applicable GLM staging system (the 1st edition of GLM stage). The system demonstrated good predictive outcomes and provided strong support for clinical decision-making.
肉芽肿性小叶性乳腺炎（GLM）的预后一直较差，主要原因是缺乏统一的疾病评估标准。
本队列研究的目的是建立一种GLM分期系统，以更准确地评估患者的预后。
本研究回顾性收集了2017年1月至2023年12月期间来我院就诊的264例GLM患者的数据。通过逻辑回归分析，确定了与预后相关的因素，这些因素作为创建新分期系统的基础。
单因素和多因素逻辑回归分析显示，高脂血症（HR：2.031；95%CI：1.100 - 3.750）和微脓肿（HR：2.087；95%CI = 1.138 - 3.827）是影响GLM患者预后的显著独立危险因素。基于逻辑分析结果，最终建立了三个不同阶段，发现C期的AUC值最高（AUC：0.642），其次是B期（AUC：0.628），A期（AUC：0.614）最低。德龙检验显示，A期和B期的AUC值之间无显著差异（P = 0.255），B期和C期之间也无显著差异（P = 0.263）。然而，发现C期的AUC值高于A期（P < 0.001）。鉴于C期的AUC值最高，本研究选择C期作为评估GLM患者预后的最终阶段，并将其命名为GLM分期第1版。
本研究构建了一个严谨且广泛适用的GLM分期系统（GLM分期第1版）。该系统显示出良好的预测结果，为临床决策提供了有力支持。
