生殖器Paget病的临床及组织病理分析  

Clinicopathologic and immunohistochemical features of genital Paget's disease

作　　者：潘德海[1] 汪晨[1] 

机构地区：[1]北京中日友好医院皮肤科,北京100029

出　　处：《临床皮肤科杂志》2004年第9期529-531,共3页Journal of Clinical Dermatology

摘　　要：目的:探讨影响生殖器Paget病(genital Paget’s disease,GP)的发生、复发及预后的因素,提高GP的治愈率。方法:对4例GP病患者的临床、病理特点、特殊染色(如PAS、阿新蓝染色等)、免疫组化(如EMA抗体、CEA抗体染色)以及抗抑癌基因p16和APC的抗体,尤其是对4例患者皮损边缘部进行了连续切片的病理进行了分析。结果:4例患者的皮损自出现瘙痒至组织学诊断历时10个月～7年;部分肿瘤细胞胞质的PAS、阿新蓝染色阳性;肿瘤细胞的EMA和CEA均阳性,APC和p16阴性。临近皮损边缘约1 cm的临床正常皮肤标本,病理显示棘层不规则肥厚。结论:GP的Paget细胞具有腺癌的特性。手术中无肿瘤细胞边缘的选择应参考连续病理切片。术后需长期随访。Objective: To understand the factors for development, recurrence and prognosis of genital Paget's disease (GP). Methods: In four patients with GP immunohistochemical staining was performed by using monoclonal antibodies which specific to epithelial membrane antigen (EMA), carcinoembryonoic antigen (CEA),p16 antigen and APC antigen. PAS staining and alcian blue staining were also carried out. The serries sections were made especially at the margins of lesions. Clinic data were also analyzed. Results: The duration from manifestation of symptoms to diagnosis varied from 10 months to 7 years. All skin samples were positive to PAS, alcian blue, CEA and EMA, but negative to APC and p16. Normal histology was identified at the margins of all biopsies, which was negative to PAS. Conclusions: Paget's cells in the GP lesions are positive to CEA and EMA, but negative to p16 and APC, which suggests that Paget's cells in GP possess characteristics of adenocarcinoma. The negative surgical margins need to be identified by skin pathology. It is essential to follow up for a long term after operation.

关 键 词：PAGET病 生殖器 肿瘤 生殖器 组织病理学 免疫组化 

分 类 号：R737[医药卫生—肿瘤]