Ganjei P, Giraldo K A, Lampe B, Nadji M
Department of Pathology, University of Miami/Jackson Memorial Medical Center, Florida.
J Reprod Med. 1990 Nov;35(11):1002-4.
From January 1977 to December 1988, 19 patients with biopsy-proven Paget's disease of the vulva underwent simple or radical vulvectomy at the University of Miami/Jackson Memorial Medical Center. All vulvectomy specimens were evaluated immunocytochemically for the expression of carcinoembryonic antigen (CEA), epithelial membrane antigen (EMA) and low-molecular-weight keratins 8 and 18 (LMK), both in areas containing neoplastic cells and in histologically negative surgical margins. Neoplastic Paget's cells stained positively for CEA in all cases; they were positive for EMA and LMK in 18 and 17 cases, respectively. In all eight cases with underlying in situ or invasive carcinomas, CEA, EMA and LMK were localized in the underlying tumors as well. None of the histologically proven negative margins reacted for CEA, EMA or LMK on immunocytochemistry. CEA appears to be a valuable immunocytochemical marker for extramammary Paget's disease; EMA and LMK are also expressed by the majority of such cases. None of these markers, however, is of added value in identifying Paget's cells in surgical margins if those margins appear negative on routine hematoxylin-and-eosin staining.
1977年1月至1988年12月期间，19例经活检证实为外阴佩吉特病的患者在迈阿密大学/杰克逊纪念医学中心接受了单纯或根治性外阴切除术。对所有外阴切除标本进行免疫细胞化学评估，检测癌胚抗原（CEA）、上皮膜抗原（EMA）以及低分子量角蛋白8和18（LMK）在含有肿瘤细胞区域和组织学检查为阴性的手术切缘中的表达情况。所有病例中，肿瘤性佩吉特细胞CEA染色均呈阳性；18例和17例分别对EMA和LMK呈阳性。在所有8例伴有原位癌或浸润癌的病例中，CEA、EMA和LMK在其下方肿瘤中也呈阳性。组织学检查证实为阴性的切缘，免疫细胞化学检测CEA、EMA或LMK均无反应。CEA似乎是一种用于乳腺外佩吉特病的有价值的免疫细胞化学标志物；大多数此类病例也表达EMA和LMK。然而，如果手术切缘在常规苏木精-伊红染色中呈阴性，这些标志物在识别切缘中的佩吉特细胞方面均无额外价值。
