Dermatopathology, USF Health Morsani College of Medicine, Tampa, Florida, USA
J Clin Pathol. 2020 Mar;73(3):172-175. doi: 10.1136/jclinpath-2019-206147. Epub 2019 Oct 29.
Intraepithelial sebaceous neoplasia in the forms (or subclassification) of pagetoid spread and carcinoma in situ is a common feature of periocular sebaceous carcinoma and is associated with less favourable outcomes. Seminal studies of periocular sebaceous carcinoma in the 1980s indicated that the two patterns of intraepithelial spread had differing influences on prognosis with pagetoid invasion being worse. Later studies reported conflicting results, but careful inspection of those studies revealed considerable variation in what was meant by pagetoid invasion. Different interpretations of pagetoid spread continue, leading to ambiguous results in clinical studies and miscommunication with potential unintended decisions affecting clinical management. This paper reviews the background leading to the frequent interchangeable use of pagetoid spread with in situ sebaceous carcinoma and how this problem confounds interpretation of clinical studies. The author recommends that for effective communication, all morphological patterns of in situ spread of sebaceous carcinoma fall under the term , which can be accompanied by subclassification whenever desired.
上皮内皮脂腺肿瘤以派杰样播散和原位癌的形式（或亚分类）是眼周皮脂腺癌的常见特征，与预后不良相关。20 世纪 80 年代对眼周皮脂腺癌的开创性研究表明，两种上皮内播散模式对预后的影响不同，派杰样浸润更差。后来的研究报告了相互矛盾的结果，但仔细检查这些研究发现，派杰样浸润的含义存在很大差异。对派杰样播散的不同解释仍在继续，导致临床研究结果模棱两可，并与潜在的无意决策造成临床管理的沟通不畅。本文回顾了导致派杰样播散与原位皮脂腺癌频繁互换使用的背景，以及这个问题如何混淆对临床研究的解释。作者建议，为了有效沟通，所有原位播散的形态学模式都归入术语，只要需要，可随时进行亚分类。
