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目的探讨阴囊Paget病的临床特点和诊治方法,提高对阴囊Paget病的诊治水平。方法对1990年至2003年收治的12例阴囊Paget病的病理、临床表现、治疗及预后进行回顾性研究,12例患者组织活检确诊后行手术治疗,术中、术后均未行化疗或放疗。结果12例病理检查可见Paget病的典型特征;11例获随访,随访时间1~13年,平均5年3个月;1例淋巴结转移者,术后2年死于广泛转移;1例术后3年局部复发,再行广泛切除,至今17个月未见复发;1例术后5年出现腹股沟淋巴结转移,1年后死于肿瘤转移;余8例无复发。结论阴囊Paget病应尽早行皮肤活检确诊,局部广泛切除是首选治疗方法,切缘阴性是预防复发的关键。
Objective To investigate the clinical features and diagnosis and treatment of Paget’s disease and to improve the diagnosis and treatment of Paget’s disease. Methods The pathology, clinical manifestation, treatment and prognosis of Paget’s disease in 12 cases scrotal collected from 1990 to 2003 were retrospectively studied. Twelve patients were surgically treated with biopsy and no chemotherapy or radiotherapy was performed during and after operation . Results The pathological findings of 12 cases showed typical features of Paget disease. Eleven cases were followed up for 1 ~ 13 years with an average of 5 years and 3 months. One case of lymph node metastasis died of extensive metastasis 2 years after operation. One case had postoperative Three years of local recurrence, and extensive resection, so far no recurrence 17 months; 1 case 5 years after inguinal lymph node metastasis, died of tumor metastasis after 1 year; more than 8 cases without recurrence. Conclusion Scrotal Paget’s disease should be confirmed by skin biopsy as early as possible. It is the first choice for the treatment of scrotal Paget disease. Negative margins are the key to prevent recurrence.