Pattern,depth And Significance Of The Adnexal Involvement In Primary Extramammary Paget's Disease

[Purpose]1.To analyze the types,proportion and depth of tumor cells involving skin appendages including hair follicles,sweat glands and sebaceous glands in primary extramammary paget's disease,and to provide theoretical basis for the selection of appropriate treatments.2.To analyze the differences in the pattern and depth of adnexal involvement between in situ and invasive primary extramammary paget's disease and then to assess its relationship with progression.[Methods]34 cases of primary extramammary paget's disease were selected.The specific types and proportions of the involvement of tumor cells in skin appendages including hair follicles,sweat glands and sebaceous glands were statistically analyzed.The depth of invasion of tumor cells was measured by image scope software.The significance was discussed by comparing the patterns and depth of adnexal involvement between in situ and invasive groups.[Results]1.The total involvement rate of skin appendages was 91.18%(31/34)and the rate of hair follicles involvement was 85.29%(29/34),while those of sweat and sebaceous glands were 52.94%(18/34)and 11.76%(4/34),respectively.with regard to the model of involvement,hair follicles combined with sweat glands were involved in 41.18%(14/34)of the cases,followed by 32.35%(11/34)of the hair follicles alone.The deepest depth of the adnexal involvement in primary EMPD is 4.69mm and the average depth was 2.38±1.25 mm,while the depth of hair follicle involvement was 1.84±1.09 mm,the depth of sweat gland involvement was 2.99±0.98 mm,the depth of sebaceous gland was 1.35±0.51 mm.2.There was no significant difference in the total involvement rate of the appendage,the structure of the single appendage and the pattern of involvement between the primary EMPD in situ and invasive groups(P>0.05);and no significant difference in the depth of the adnexal involvement,the depth of involvement in hair follicle and sweat gland between in situ and invasive groups was detected as well(u>0.05).[Conclusion](1)The adnexal involvement is a common phenomenon in primary EMPD.Hair follicles are the most commonly involved appendages,while the pattern of hair folliclesc combined with sweat glands are the most type of involvement.(2)The deepest depth of the adnexal involvement in primary EMPD is 4.69mm and the average depth was 2.38 mm.It is necessary to take this factor into consideration and choose the appropriate treatment.(3)The pattern and depth of adnexal involvement by tumor cells in primary EMPD were not significantly related to the progression of the disease.