Clinicopathological Study On Paget's Disease And Its Pathogenesis

Purpose To investigate the clinicopathological features of paget's disease and its pathogenesis. Methods 1. 61 cases of paget's disease(PD) including 50 cases of mammary paget's disease(MPD) and 11 cases of extramammary paget's disease(EMPD) were observed under light microscopy with stains of hematoxylin eosin.l case of MPD ,1 case of EMPD and 1 case of pagetoid Bowen's disease(PBD) were study by electron microscope. 2. 61 cases of PD were stained with diastase periodic acid-Schiff (PAS) and alcian blue(AB) at pH 2.5 to detect the presence of mucin. 3. immunohistochemical staining,S-P methe,was used to detect the positity of GCDFP-15, Muc-1, CK8 and AE3 in 61 cases of PD. 8 cases of apocrine carcinoma of the breast(AC) and 46 cases of breast carcinoma(BC) with MPD were comparised. 4. double immunohistochemical staining was used to observed the relation of expression of CK8 and AE3 , GCDFP-15 and AR. Results 1. Five type of configurations of PD cell were observed, including spread separate in epidermis, linear arrays in the basal layer, papillary structures formatted, glandulose arrange and nest structure. 2. Morphologically, features of cell of MPD showed similarity to the BC cell. Four type features of EMPD cell were revealed, including signet-ring cell, apocrine carcinoma cell, sebaceous gland cell, common adenocarcinoma cell. 3. Ultrastructurally, the tumour cells of MPD and EMPD displayed glandular differentiation , having abundant cytoplasmic glycogen and secrete canaliculus. No phenomenon of cytoplasmic secretion was obsreed in PBD. 4. The positity rateof AB in MPD and EMPD were 6%(3/50), 36%(4/ll) respectively. In MPD, the expression was significant lower than that in EMPD(P < 0.05). The expression of PAS in MPD and EMPD were 76%(38/50), 27%(3/ll) respectively. In EMPD, the expression was significant lower than that in MPD(P < 0.05). 5. The expression of GCDFP-15.Muc-l and CK8 in MPD were 2%(1/50).92%(46/50) and 88%(44/50) respectively, in EMPD were 18%(2/11).36%(4/11) and 81%(9/U) respectively, The...