国际妇产科学杂志 ›› 2020, Vol. 47 ›› Issue (4): 456-461.

• 综述 • 上一篇    下一篇

外阴Paget病的诊治进展 

房园园,谢满鑫,方钦,邢燕△   

  1. 210029  南京医科大学第一附属医院妇产科
  • 收稿日期:2020-01-16 修回日期:2020-04-19 出版日期:2020-08-15 发布日期:2020-08-15
  • 通讯作者: 邢燕,E-mail:13951891712@163.com E-mail:123@qq.com
  • 基金资助:
    江苏省妇幼健康重点课题(F201718)

Progress in Diagnosis and Treatment of Vulvar Paget Disease

FANG Yuan-yuan,XIE Man-xin,FANG Qin,XING Yan   

  1. Department of Obstetrics and Gynecology,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China
  • Received:2020-01-16 Revised:2020-04-19 Published:2020-08-15 Online:2020-08-15
  • Contact: XING Yan,E-mail:13951891712@163.com E-mail:123@qq.com

摘要: 外阴Paget病是一种罕见的皮肤恶性肿瘤,好发于绝经后妇女,常表现为外阴瘙痒、局部疼痛或烧灼感,病灶主要表现为外阴皮肤的红斑或湿疹样改变。确诊依赖于病理活检,分为原发型外阴Paget病和继发型外阴Paget病这2种病理类型,借助免疫组织化学染色常可对外阴Paget病进行较为明确的鉴别诊断。因其临床表现具有非特异性及病理特征不典型,该病的误诊率及延后诊断率较高。手术治疗是外阴Paget病的首选治疗方案,但手术范围的制定是目前治疗的难点,手术范围过大常导致严重的组织损伤及功能障碍。近年来外用咪喹莫特乳膏、光动力治疗等为其保守性治疗提供了新思路。无论采取手术治疗或保守治疗,外阴Paget病的复发率较高,其预后主要与病理类型、淋巴结的转移与否、浸润深度密切相关,因此需要对外阴Paget病的患者进行长期随访。现对外阴Paget病的诊断、治疗等方面的进展进行综述。

关键词: 外阴Paget病;, 绝经后期, ;佩吉特病, 乳腺外;, 皮肤;, 外阴肿瘤;, 诊断;, 治疗

Abstract: Vulvar Paget disease is a rare malignant tumor of the skin that usually occurs in postmenopausal women. It causes symptoms such as itching, local pain or burning sensation of the vulva. It usually presents as erythema or eczema-like changes of the skin of the vulva. The diagnosis is confirmed by pathological biopsy. Vulvar Paget disease can be classified into primary and secondary vulvar Paget disease. Immunohistochemical stains can be used to make a relatively clear differential diagnosis of vulvar Paget disease. Due to its non-specific clinical manifestations and atypical pathological features, the rate of misdiagnosis and delayed diagnosis is high. Surgical treatment is the first choice for the treatment of vulva Paget disease. However, the formulation of surgical scope is a difficulty of current treatment. If the surgical scope is too large, it may cause serious tissue damage and dysfunction. Topical imiquimod cream and photodynamic therapy have provided new ideas for the conservative treatment in recent years. Regardless of surgical treatment or conservative treatment, the recurrence rate of vulvar Paget disease is high. Its prognosis is closely related to pathological type, lymph node metastasis and infiltration depth. It is necessary to conduct long-term follow up for patients with the disease. This article will review the progress in diagnosis and treatment of vulva Paget disease.

Key words: Vulvar Paget disease;, Postmenopause;, Paget disease, extramammary;, Skin;, Vulvar neoplasms;, Diagnosis, Therapy