佩吉特【Paget】病18例诊治分析

目的提高对佩吉特【Paget】病的诊治水平。方法回顾性分析1989～2005年收治的18例Paget病的临床表现及诊治方法。结果本组乳腺Paget病6例,乳腺外12例,其中阴茎、阴囊10例,腹股沟处1例,肛周肛管1例。随访时间0.5～11年,平均5年4个月,随访中3例复发,其截端切片病理检查均可见病变组织,另1例死于其他疾病。结论本病的诊断主要依靠病理检查。手术是唯一有效治疗措施,手术时病灶切除必须彻底,截端组织病理检查无病变组织才能防止术后复发。

Objective The clinical signs of Paget＇s disease are similar to those of chronic eczema.The two are often confused, expecially estramammary Paget＇s disease.Only biopsy can help to differentiate them correctly.Methods 18 patients with Paget＇ s disease were reviwed with regard to clinical analysis and treatment from 1989 to 2005.Results Six patients had breast Paget＇ s disease and !2 had extramammary one.The latter involved scrotum and penis in 10 patients,the groin in I ,and perianal and anal in 1.Follow up showed that 3 patients had recurrences in extramammary patients who had had positive surgical margin biopsy.One patient died of other disease.Conclusion Surgery is the first choice of treatment for Paget＇s disease either of breast or of extramammary regions. Negative margins must be achieved to prevent local recurrence.