Scheistrøen M, Tropé C, Kaern J, Pettersen E O, Alfsen G C, Nesland J M
Department of Gynecologic Oncology, Norwegian Radium Hospital, Oslo.
Gynecol Oncol. 1997 Jan;64(1):88-92. doi: 10.1006/gyno.1996.4517.
Clinical data were retrieved from the hospital records of 34 patients with Paget's disease of the vulva treated from 1972 to 1990. Flow-cytometric (FCM) DNA measurements and p53 and c-erbB-2 immunostaining were performed on paraffin-embedded samples. Five patients had an underlying adenocarcinoma and 29 intraepithelial disease (IEP). Twenty-seven patients with IEP underwent surgery. The surgical margins were positive in 15 patients, negative in 10, and not evaluable in 2. The tumor was diploid in 15 patients, nondiploid in 11, and not evaluable in 1. Eight patients recurred, 6/15 (40%) with positive and 2/10 (20%) with negative margins. One patient with positive margins was never disease-free. Recurrence was seen in 6/11 (55%) patients with nondiploid tumors, 4 with positive and 2 with negative margins. Two of 15 (13%) patients with diploid tumors recurred/persisted, both with positive margins. None of the 6 patients with diploid tumors and negative margins recurred. p53 and c-erbB-2 were found negative in all but 4 patients. Tumor nondiploidy was associated with an increased risk of recurrence irrespective of surgical radicality. p53 and c-erbB-2 seemed to play no role in the pathogenesis or prognosis.
我们从1972年至1990年期间接受治疗的34例外阴佩吉特病患者的医院记录中获取临床数据。对石蜡包埋样本进行了流式细胞术（FCM）DNA测量以及p53和c-erbB-2免疫染色。5例患者伴有潜在腺癌，29例为上皮内疾病（IEP）。27例IEP患者接受了手术。手术切缘阳性的患者有15例，阴性的有10例，2例无法评估。15例患者的肿瘤为二倍体，11例为非二倍体，1例无法评估。8例患者复发，切缘阳性的患者中6/15（40%）复发，切缘阴性的患者中2/10（20%）复发。1例切缘阳性的患者从未无病。非二倍体肿瘤患者中6/11（55%）复发，其中4例切缘阳性，2例切缘阴性。15例二倍体肿瘤患者中有2例（13%）复发/疾病持续存在，二者切缘均为阳性。6例二倍体肿瘤且切缘阴性的患者均未复发。除4例患者外，其余所有患者的p53和c-erbB-2均呈阴性。无论手术彻底程度如何，肿瘤非二倍体与复发风险增加相关。p53和c-erbB-2似乎在发病机制或预后中不起作用。
