Lewy R I, Ezrailson E
Baylor College of Medicine, Houston, Texas.
Curr Top Microbiol Immunol. 1996;210:337-53. doi: 10.1007/978-3-642-85226-8_36.
Silicone polymers when used in augmentation prosthesis in breast surgery have been associated in the medical literature with various systemic clinical manifestations and abnormal laboratory testing suggestive of an atypical autoimmune disease. The most frequently cited abnormal test result is the antinuclear antibody. The literature regarding this test is reviewed in general, and then specific previous studies analyzed. The present study then compares the rate of positive antinuclear antibody tests in a case series of 3380 breast implant recipients with historical normal controls, and finds a six-fold increase in relative risk of a positive test. Analysis of the data show that this increased tendency is at least partially a function of duration of implant exposure to a significant degree (p < 0.001), and the same data shows it is not patient age related. Possible explanations of this phenomenon are discussed, including animal studies suggesting that silicone serves as an adjuvant, and therefore might have an effect on immune tolerance in the subject population.
在医学文献中，乳房手术中用于隆胸假体的硅酮聚合物与各种全身临床表现以及提示非典型自身免疫性疾病的异常实验室检查结果有关。最常被引用的异常检测结果是抗核抗体。本文首先对有关该检测的文献进行了综述，然后分析了以往的具体研究。本研究随后比较了3380例乳房植入物接受者病例系列中抗核抗体检测呈阳性的比率与历史正常对照，发现检测呈阳性的相对风险增加了六倍。数据分析表明，这种增加的趋势在很大程度上至少部分是植入物暴露时间的函数（p < 0.001），同样的数据表明它与患者年龄无关。本文讨论了这一现象的可能解释，包括动物研究表明硅酮可作为佐剂，因此可能对受试人群的免疫耐受性产生影响。
