乳房外Paget病19例临床与随访分析

发布时间：2018-04-03 15:47

本文选题：Paget病　切入点：乳腺外　出处：《中国皮肤性病学杂志》2011年08期

【摘要】：目的探讨乳房外Paget病的临床、病理特点及影响生存率的因素。方法回顾性分析2000-2010年间本院收治的19例乳房外Paget病患者的临床资料。结果 19例中女4例,男15例,平均年龄(70.26±8.90)岁。确诊时病程1月~6.5年,平均43月。临床表现主要为红斑、糜烂及湿疹、皮炎样皮损。手术治疗13例,其中2例复发;光动力治疗5例;未治疗1例。随访期间死亡7例,5年生存率61.20%。单因素变量分析显示淋巴结转移、肿瘤细胞侵袭至真皮、伴发其他肿瘤或远处转移、CEA水平升高与患者生存率有关。结论乳房外Paget病早期诊断困难,复发率高,淋巴结转移、伴发肿瘤或远处转移者预后差,需长期随访。迁延不愈的"湿疹"患者应尽早行皮肤活检,免疫组化检查可提高早期诊断率并指导早期治疗。
[Abstract]:Objective to investigate the clinical and pathological features of extramammary Paget's disease and the factors affecting survival rate.Methods the clinical data of 19 patients with extramammary Paget's disease from 2000 to 2010 were retrospectively analyzed.Results among 19 cases, 4 cases were female, 15 cases were male, the average age was 70.26 卤8.90 years old.The course of disease was from 1 month to 6.5 years, with an average of 43 months.The main clinical manifestations were erythema, erosion, eczema and dermatitis.13 cases were treated with operation, 2 cases with recurrence, 5 cases with photodynamic therapy and 1 case without treatment.The 5-year survival rate was 61. 20%.Univariate analysis showed that lymph node metastasis, invasion of tumor cells into the dermis, and increased CEA levels in other tumors or distant metastasis were associated with survival rate.Conclusion the early diagnosis of extramammary Paget's disease is difficult, the recurrence rate is high, the lymph node metastasis, the prognosis of the patients with tumor or distant metastasis is poor, it is necessary to follow up for a long time.Skin biopsy should be performed as early as possible in patients with prolonged eczema. Immunohistochemical examination can improve the early diagnosis rate and guide early treatment.
【作者单位】：浙江大学医学院附属邵逸夫医院皮肤科;
【分类号】：R739.5

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