Liegl Bernadette, Horn Lars-Christian, Moinfar Farid
Department of Pathology, Medical University of Graz, Graz, Austria.
Mod Pathol. 2005 Oct;18(10):1283-8. doi: 10.1038/modpathol.3800437.
Mammary Paget's disease and extramammary Paget's disease are rare intraepithelial neoplasms. Mammary Paget's disease is almost exclusively associated with underlying invasive breast carcinoma or high-grade ductal carcinoma in situ (DCIS G3). Extramammary Paget's disease arises in areas rich in apocrine glands and is suspected to have apocrine gland origin. The aim of the study was to investigate the presence of estrogen receptor (ER), progesterone receptor (PR), androgen receptor (AR) and Her2/neu in a large number of cases. We investigated 58 cases of mammary and 23 cases of extramammary Paget's disease. Formalin-fixed and paraffin-embedded tissues were analyzed using antibodies against AR, PR, ER and Her2/neu according to standardized procedures. In mammary Paget's disease, positive immunoreactions for Her2/neu, AR and ER were observed in 56 of 58 (97%), 51 of 58 (88%), and respectively in six of 58 (10%) cases. All cases of mammary Paget's disease were negative for PR and showed a coexpression of Her2/neu and AR in 51 out of 58 cases (88%). In extramammary Paget's disease, positive immunoreactions for AR, Her2/neu and ER were observed in 18 of 23 (78%), 12 of 23 (52%), and respectively in 1 of 23 (4%) cases. All cases of extramammary Paget's disease were negative for PR and showed a coexpression of AR and Her2/neu in 12 out of 23 cases (52%). In contrast to ER and PR, AR and Her2/neu are commonly expressed in mammary and extramammary Paget's disease. The knowledge about frequent expression of AR in Paget's disease could lead to the development of a new adjuvant therapy, particularly in patients with recurrent disease.
乳腺佩吉特病和乳腺外佩吉特病是罕见的上皮内肿瘤。乳腺佩吉特病几乎仅与潜在的浸润性乳腺癌或高级别导管原位癌(DCIS G3)相关。乳腺外佩吉特病发生于富含顶泌汗腺的区域,怀疑起源于顶泌汗腺。本研究的目的是调查大量病例中雌激素受体(ER)、孕激素受体(PR)、雄激素受体(AR)和Her2/neu的表达情况。我们调查了58例乳腺佩吉特病和23例乳腺外佩吉特病。按照标准化程序,使用抗AR、PR、ER和Her2/neu的抗体对福尔马林固定、石蜡包埋的组织进行分析。在乳腺佩吉特病中,58例中有56例(97%)Her2/neu呈阳性免疫反应,58例中有51例(88%)AR呈阳性免疫反应,58例中有6例(10%)ER呈阳性免疫反应。所有乳腺佩吉特病病例PR均为阴性,58例中有51例(88%)Her2/neu和AR共表达。在乳腺外佩吉特病中,23例中有18例(78%)AR呈阳性免疫反应,23例中有12例(52%)Her2/neu呈阳性免疫反应,23例中有1例(4%)ER呈阳性免疫反应。所有乳腺外佩吉特病病例PR均为阴性,23例中有12例(52%)AR和Her2/neu共表达。与ER和PR不同,AR和Her2/neu在乳腺和乳腺外佩吉特病中通常呈阳性表达。关于佩吉特病中AR频繁表达的认识可能会促使开发新的辅助治疗方法,尤其是对复发患者。