Department of Dermatology, Eberhard-Karls-University, Tuebingen, Germany.
Dermatol Surg. 2011 Oct;37(10):1417-26. doi: 10.1111/j.1524-4725.2011.02091.x. Epub 2011 Jul 18.
Extramammary Paget's disease (EMPD) is a rare tumor of the skin characterized by extended irregular subclinical growth and high recurrence rates after surgery.
To show that, using three-dimensional (3D) histology in surgical excision, the size of the safety margin can be individually determined and locally adjusted to subclinical growth and to evaluate the course of the disease in 33 patients.
The clinical records of 33 patients with primary lesions of EMPD were prospectively documented, retrospectively confirmed, and analyzed.
EMPD was found more frequently in women (54.5%). Dermal invasion was found in 21.2%, and regional lymph node metastases were present in one patient; 30.3% of the patients had secondary internal malignancies. In 25 cases examined using 3D histology, a mean surgical margin of 22 mm in asymmetric shape (range 5-65 mm) was achieved, with a recurrence rate of 28%. Surgery with conventional histologic examination had a higher recurrence rate of 62.5% using a mean surgical margin of 19 mm (range 7-40 mm).
Subclinical spread of EMPD demonstrated using 3D histology with paraffin sectioning can be large. Three-dimensional histology allows individually defined safety margins to be locally adjusted to subclinical growth and gives low recurrence rates. The authors have indicated no significant interest with commercial supporters.
派杰氏病（EMPD）是一种罕见的皮肤肿瘤，其特征为广泛的无临床症状的不规则性生长以及手术后高复发率。
展示使用三维（3D）组织学在外科切除术中，安全边界的大小可以个体化确定，并根据亚临床生长进行局部调整，并评估 33 例患者的疾病过程。
前瞻性地记录、回顾性确认并分析了 33 例原发性 EMPD 患者的临床记录。
EMPD 更常见于女性（54.5%）。21.2%存在真皮浸润，1 例存在区域淋巴结转移；30.3%的患者存在继发性内脏恶性肿瘤。在 25 例接受 3D 组织学检查的病例中，平均手术边界为 22mm（不对称形状，范围 5-65mm），复发率为 28%。使用常规组织学检查的手术，平均手术边界为 19mm（范围 7-40mm），复发率更高，为 62.5%。
石蜡切片的 3D 组织学显示 EMPD 的亚临床扩散可能很大。3D 组织学允许根据亚临床生长个体化确定安全边界，并获得低复发率。作者表示没有与商业支持者的重大利益关系。
