Battles O E, Page D L, Johnson J E
Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee 37232-2561, USA.
Am J Clin Pathol. 1997 Jul;108(1):6-12.
To identify a sensitive marker for extramammary Paget's disease and to identify histochemical and immunohistochemical features that suggest occult pelvic cancer in patients with extramammary Paget's disease, we retrieved all cases between 1983 and 1992 with a Standardized Nomenclature of Medicine code of extramammary Paget's disease in the Vanderbilt University Medical Center (Nashville, Tenn) surgical pathology archives. All were stained for alcian blue/dPAS (periodic acid-Schiff), mucicarmine, AE1/AE3, cytokeratin (CAM 5.2), cytokeratin (CK) 7, CK 20, carcinoembryonic antigen (CEA), orthokeratin, prostate-specific antigen, and S-100. Sixteen cases (2 men, 14 women) were retrieved. Two had pelvic malignancies: one rectal adenocarcinoma and one transitional carcinoma. Only CK7 marked all cases. Mucins were sensitive but focal, a potential problem in small biopsy specimens. The transitional tumor had a unique staining profile (CEA- and mucin-negative). CK20 strongly marked Paget cells associated with rectal cancer; its presence suggests a large bowel lesion but is not specific. No case expressed prostate-specific antigen; its presence in a man suggests prostatic carcinoma.
为了确定一种针对乳腺外佩吉特病的敏感标志物，并确定提示乳腺外佩吉特病患者隐匿性盆腔癌的组织化学和免疫组化特征，我们检索了范德比尔特大学医学中心（田纳西州纳什维尔）手术病理档案中1983年至1992年间所有医学标准化命名代码为乳腺外佩吉特病的病例。所有病例均进行了阿尔辛蓝/过碘酸希夫染色（dPAS）、黏液卡红染色、AE1/AE3染色、细胞角蛋白（CAM 5.2）染色、细胞角蛋白（CK）7染色、CK 20染色、癌胚抗原（CEA）染色、正角化蛋白染色、前列腺特异性抗原染色和S-100染色。共检索到16例病例（2例男性，14例女性）。其中2例有盆腔恶性肿瘤：1例直肠腺癌和1例移行细胞癌。只有CK7在所有病例中均呈阳性。黏液染色敏感但呈局灶性，这在小活检标本中可能是个问题。移行性肿瘤有独特的染色模式（CEA和黏液均为阴性）。CK20在与直肠癌相关的佩吉特细胞中呈强阳性；其存在提示大肠病变，但不具有特异性。没有病例表达前列腺特异性抗原；男性病例中出现该抗原提示前列腺癌。
