CAJ | 학술논문

目的：通过对97例乳房外Paget病患者临床资料回顾性研究，分析其皮损部位及组织病理及免疫组化特点。方法收集我科2003年9月—2011年12月收治的97例乳房外Paget病患者临床资料，对其皮损部位及组织病理特点进行回顾性分析。结果乳房外Paget病男女均可发病，男性发病多于女性，平均发病年龄为63岁。皮损主要发生于顶泌汗腺分布较丰富的区域，如阴囊、阴茎、会阴、肛周、阴唇、阴阜等部位，少部分发生于腹股沟、腋窝、前胸、臀部。本病临床上易误诊。典型的组织病理表现为表皮内散在或成团块状分布的Paget细胞。免疫组化染色显示CEA、CDX2、CAM5.2（CK8/18）阳性，S-100蛋白、EMA等阴性，有利于鉴别，而CK7和CK20在不同部位的表达总分不一致。结论对乳房外Paget病早期行组织病理检查有利于减少临床误诊。
목적：통과대97례유방외Paget병환자림상자료회고성연구，분석기피손부위급조직병리급면역조화특점。방법수집아과2003년9월—2011년12월수치적97례유방외Paget병환자림상자료，대기피손부위급조직병리특점진행회고성분석。결과유방외Paget병남녀균가발병，남성발병다우녀성，평균발병년령위63세。피손주요발생우정비한선분포교봉부적구역，여음낭、음경、회음、항주、음진、음부등부위，소부분발생우복고구、액와、전흉、둔부。본병림상상역오진。전형적조직병리표현위표피내산재혹성단괴상분포적Paget세포。면역조화염색현시CEA、CDX2、CAM5.2（CK8/18）양성，S-100단백、EMA등음성，유리우감별，이CK7화CK20재불동부위적표체총분불일치。결론대유방외Paget병조기행조직병리검사유리우감소림상오진。
Objective Through the study of 97 cases of extramammary Paget's disease to analyze its clinical and pathological features. Methods A total of 97 cases of extramammary Paget's disease were treated in our department from September 2003 to December 2011, and their clinical manifestations, pathological features, treatment options and prognosis were retrospectively analyzed here. Results Both male and female could get extramammary Paget's disease, more male than female. Extramammary Paget's disease occurred mainly in apocrine sweat glands distributed rich region. It occurred mainly in the scrotum, penis, perineum, crissum, labia and monsveneris, and a small fraction occurred in the groin, armpits, chest and buttocks, which mostly occurs in scrotum. It should be identiifed with eczema, Bowen's disease and other diseases, clinically misdiagnosed. Typical pathological manifestations were scattered or lumps of Paget's cells in the epidermis. Immunohistochemistry stain showed that the expression of CEA, CDX2 and CAM5.2 (CK8/18) were positive, and negative for S-100 and EMA, this facilitated the distinguishing of the disease from the others. The expression of CK7 and CK20 was not consistent in different parts. Conclusion Early biopsy is helpful to reduce the misdiagnosis.