CAJ | 학술논문

目的：探讨黏蛋白2（MUC2）和细胞角蛋白20（CK20）在乳房外佩吉特病（EMPD）中的表达情况及两者之间的关系。方法应用生物素蛋白免疫组织化学法（SP 法）检测24例 EMPD 及10名美容切除术后正常组织上 MUC2与 CK20的表达。结果24例 EMPD 常规苏木素-伊红（HE）染色显示：11例为原位性佩吉特病：Paget 细胞局限在上皮内；13例为浸润性佩吉特病：Paget 细胞穿破基底膜浸润到真皮及皮下脂肪。11例原位性 EMPD 细胞质中 CK20表达中等强度阳性1例，弱阳性5例，阴性5例；13例浸润性 EMPD 细胞质中 CK20表达强阳性9例，阳性4例；10例正常皮肤细胞质中 CK20表达4例弱阳性，6例阴性。11例原位性 EMPD 细胞质中 MUC2表达阳性1例，弱阳性7例，阴性3例；13例浸润性 EMPD 中 MUC2表达强阳性13例；10例正常皮肤中 MUC2表达6例弱阳性，4例阴性。浸润性 EMPD 中 MUC2的阳性细胞表达明显高于 CK20（P<0.05），原位性EMPD中 CK20与 MUC2之间的阳性表达差异无统计学意义（P＞0.05）。结论 MUC2在浸润性 EMPD 中的阳性细胞表达明显高于 CK20的阳性表达，MUC2可能是 EMPD 发生发展中的重要因子，可能在 EMPD 的侵袭和转移中起着重要作用。在 EMPD 中联合检测 MUC2和 CK20，有助于对 EMPD 做出更为明确的诊断，指导临床治疗和预防。
목적：탐토점단백2（MUC2）화세포각단백20（CK20）재유방외패길특병（EMPD）중적표체정황급량자지간적관계。방법응용생물소단백면역조직화학법（SP 법）검측24례 EMPD 급10명미용절제술후정상조직상 MUC2여 CK20적표체。결과24례 EMPD 상규소목소-이홍（HE）염색현시：11례위원위성패길특병：Paget 세포국한재상피내；13례위침윤성패길특병：Paget 세포천파기저막침윤도진피급피하지방。11례원위성 EMPD 세포질중 CK20표체중등강도양성1례，약양성5례，음성5례；13례침윤성 EMPD 세포질중 CK20표체강양성9례，양성4례；10례정상피부세포질중 CK20표체4례약양성，6례음성。11례원위성 EMPD 세포질중 MUC2표체양성1례，약양성7례，음성3례；13례침윤성 EMPD 중 MUC2표체강양성13례；10례정상피부중 MUC2표체6례약양성，4례음성。침윤성 EMPD 중 MUC2적양성세포표체명현고우 CK20（P<0.05），원위성EMPD중 CK20여 MUC2지간적양성표체차이무통계학의의（P＞0.05）。결론 MUC2재침윤성 EMPD 중적양성세포표체명현고우 CK20적양성표체，MUC2가능시 EMPD 발생발전중적중요인자，가능재 EMPD 적침습화전이중기착중요작용。재 EMPD 중연합검측 MUC2화 CK20，유조우대 EMPD 주출경위명학적진단，지도림상치료화예방。
Objective To analyze the expression of mucin 2 (MUC2) and cytokeratin 20 (CK20) in extramam-mary Paget′s disease (EMPD), and to explore the correlation between these two markers. Methods The MUC2 and CK20 expression profiles in 24 cases of EMPD and 10 cases of normal tissues derived from cosmetic surgery were ex-amined by immunohistochemistry assay of biotinylated proteins. Results Results of routine haematoxylin-eosin (HE) staining of EMPD (n=24) showed that 11 cases harbored in situ Paget′s disease (Paget′s cells restricted within the ep-ithelium), and 13 cases had infiltrative Paget′s disease (Paget′s cells invading the basilar membrane, infiltrating the dermis and subcutaneous adpipose tissue). The expression of CK20 in 11 cases with intraepithelial EMPD showed a single case presenting with moderately positive findings, 5 with weakly positive findings and 5 with negative findings. Of the 13 cases with infiltrative Paget′s disease, 9 yielded strongly positive expression and 4 positive expression of CK20. Of the 10 cases with normal skin, 4 cases demonstrated weakly positive expression and 6 negatively expression of CK20. Of the 11 cases with intraepithelial EMPD, a single case yielded positive expression, 7 weakly positive ex-pression and 3 negative expression of MUC2. Of the 13 cases with infiltrative EMPD, 13 cases elicited strongly posi-tive expression of MUC2. Of the 10 cases with normal skin, 6 presented with weakly positive expression and 4 nega-tive expression of MUC2. The positive expression of MUC2 was significantly higher than CK20 in infiltrative EMPD (P<0.05). The difference in the positive expression between CK20 and MUC2 in intraepithelial EMPD did not achieve statistical significance (P>0.05). Conclusion The positive expression of MUC2 is significantly higher than CK20 in infiltrative EMPD. MUC2 may have played an important role in the pathogenesisn and development of EMPD, and may be associated with the invasion of tumor cells. MUC2 could have played a pivotal role in the invasion and metas-tasis of EMPD. The combined detection of MUC2 and CK20 in EMPD contributes to make clear diagnosis for EMPD, to clinically evaluate the invasion of EMPD, and to guide clinical treatment and prevention.