女性乳头湿疹样癌与乳腺癌浸润乳头之间区别的探讨

The Discussion on The Difference Between Paget's Diseae of the Nipple and Involvment of the Nipple of Carcinoma of the Breast

本文对１９８０～１９８２年间．天津肿瘤医院收治可手术原发女性乳腺癌７１５侧重新复习。根据镜下在乳头皮肤见到ｐａｇｅｔ细胞以及癌直接浸润（或累及）乳头，确定乳头湿疹样癌２０例，乳腺癌浸润乳头６９例。比较两组在临床表现、病理形态和预后的差异。结果发现，乳头湿疹样癌的临床表现以乳头糜烂，结痂为主，而乳腺癌浸润乳头则以乳头凹陷、皮肤粘连、桔皮样变和乳头抬高为主；镜下形态，乳头湿疹样癌主要是在乳头表皮内见到Ｐａｇｅｔ细胞，晚期亦可浸及乳头基质。乳腺癌浸润乳头主要特点是癌细胞浸润乳腺导管，管壁可完整或被浸破，癌亦可直接浸润乳头基质，绝大多数皮肤正常，直接累及皮肤少见，均无Ｐａｇｅｔ细胞。通过本文研究，作者认为乳头湿疹样癌为乳腺癌的独立类型，其在临床表现、病理形态及预后等方面，均与乳腺癌浸润乳头有显著区别。

etween 1980 and 1982,20 women with Paget's disease of the nipple (PDN)and 69 women with involvement of the nipple of carcinoma of the breast(INCB).were confirmed histopathologically among a to-tal of 715 potients with primary operable breast cancer at Tidnjin Cdncer Hospital and Instituete,A compari-son was made between PDN and INCB in clinic symptom,pdthologic morphology and prognosis.Resultswere following:(1) Clinical symptoms were mainly erythema,erosion and crusting in PDN, and retractionof the nipple,adhesion and edema of the skin in INCB。(2)Intraepidermal Paget cells were found in a1120PDN,and stromal of the nipple can be infiltrated in some of PDN。The histologic form of involvement ofINCB included intraductal,stromal and intraductal as well asstromal(3)The survival rate in PDN is better than in INCB。