Prognostic Role of Gas6/sAXL Signaling Pathway in Predicting Treatment Resistance in Idiopathic Granulomatous Mastitis

Vollständiger Abstract

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Idiopathic granulomatous mastitis is a rare chronic inflammatory breast disease with unclear pathogenesis and unpredictable therapeutic outcomes. Although the Gas6/sAXL signaling pathway plays an important role in immune regulation, its prognostic significance in idiopathic granulomatous mastitis remains unknown. This retrospective observational cohort study included 37 women with histopathologically confirmed idiopathic granulomatous mastitis, categorized as treatment-responsive (n=18) or treatment-resistant (n=19), and 17 age- and body mass index-matched healthy controls. Treatment resistance was defined as failure to achieve remission within 24 weeks of standard pharmacotherapy, or progression/persistence of abscess or sinus tract requiring surgical intervention after at least six weeks of treatment. Pre-treatment serum and formalin-fixed paraffin-embedded tissue levels of Gas6 and sAXL were measured using enzyme-linked immunosorbent assay. Receiver operating characteristic analysis evaluated discriminatory performance, while binary logistic regression identified independent predictors of treatment resistance. Serum Gas6 levels were significantly lower in both idiopathic granulomatous mastitis subgroups compared with controls (p