外陰Paget病的臨床特點與治療分析_West China Medical Journal

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外陰上皮內瘤變; Paget病; 治療

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目的:探討外陰Paget病的臨床特點及治療方法。方法:回顧分析5例外陰Paget病的臨床資料。結果:外陰Paget病5例,年齡45～75歲,平均67.4歲。4例絕經。5例中,3 例(60%) 以瘙癢為首發癥狀,2 例(40%)因外陰結節、皮損或濕疹樣改變就診。患者治療以手術為主。其中3例行外陰單純切除術,1例因一般情況較差及內科合并癥,未行手術,給予放療。1例患者行外陰廣泛切除及腹股溝淋巴結清掃術,術后給予放療。結論:外陰Paget病多見于絕經后患者,癥狀以瘙癢為主,有就診延遲現象。治療以手術為主,可選擇外陰單純切除術或局部病灶切除,伴有浸潤性病變、合并腺癌或淋巴結轉移者常需擴大手術范圍,行外陰廣泛切除。對不能手術的患者,可給予放療。復發常見,患者均需終生隨訪。

Citation： 何躍寰. 外陰Paget病的臨床特點與治療分析. West China Medical Journal, 2009, 24(9): 2403-2404. doi: Copy

1.	SARMIENTO JM,WOLFF BG,BURGART LJ, et al. Paget’s disease of the perianal region: an aggressive disease [J]. Dis Colon Rectum, 1997, 40: 1187-1194.
2.	FANNING J,LAMBERT HC, HALE TM, et al. Paget’s disease of the vulva: p revalence of associated vulvar adenocarcinoma, invasive Paget’s disease, and recurrence after surgical excision[J]. Am J Obstet Gynecol, 1999, 180: 24-27.
3.	KODAMA S, KANEKO T, SAITO M, et al. A clinicopathologic study of 30 patients with Paget’s disease of the vulva[J]. Gynecol Oncol, 1995, 56: 63-70.
4.	TEBES S, CARDOSI R, HOFMANM. Paget’s disease of the vulvar[J]. Am J Obstet Gynecol, 2002, 187: 281-284.
5.	PARKER LP, PARKER JR, BODURKA BEVERS D, et al. Paget ’s disease of the vulva: pathology, pattern of involvement and p rognosis[J]. Gynecol Oncol, 2000, 77: 183-189.
6.	WILKINSON EJ,BROWN HM. Vulvar Paget disease of urothelial origin: a report of three cases and a p roposed classification of vulvar Paget disease[J]. Hum Pathol, 2002, 33: 549-557.

1. SARMIENTO JM,WOLFF BG,BURGART LJ, et al. Paget’s disease of the perianal region: an aggressive disease [J]. Dis Colon Rectum, 1997, 40: 1187-1194.
2. FANNING J,LAMBERT HC, HALE TM, et al. Paget’s disease of the vulva: p revalence of associated vulvar adenocarcinoma, invasive Paget’s disease, and recurrence after surgical excision[J]. Am J Obstet Gynecol, 1999, 180: 24-27.
3. KODAMA S, KANEKO T, SAITO M, et al. A clinicopathologic study of 30 patients with Paget’s disease of the vulva[J]. Gynecol Oncol, 1995, 56: 63-70.
4. TEBES S, CARDOSI R, HOFMANM. Paget’s disease of the vulvar[J]. Am J Obstet Gynecol, 2002, 187: 281-284.
5. PARKER LP, PARKER JR, BODURKA BEVERS D, et al. Paget ’s disease of the vulva: pathology, pattern of involvement and p rognosis[J]. Gynecol Oncol, 2000, 77: 183-189.
6. WILKINSON EJ,BROWN HM. Vulvar Paget disease of urothelial origin: a report of three cases and a p roposed classification of vulvar Paget disease[J]. Hum Pathol, 2002, 33: 549-557.

West China Medical Journal

外陰Paget病的臨床特點與治療分析

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