Mammary and Extramammary Paget's Disease Presented Different Expression Pattern of Steroid Hormone Receptors.

Paget's disease (PD) is a rare intraepithelial adenocarcinoma, which is composed of mammary (MPD) and extramammary Paget's disease (EMPD). Currently, the published literature contains scant data on expression pattern of steroid hormone receptors in MPD and EMPD. Expression of estrogen receptor (ER) and androgen receptor (AR) was evaluated in 88 MPD and 72 EMPD by using immunohistochemical staining and H-score method. Positive expression of AR was significantly higher in EMPD (61.11%, 44/72) than in MPD (32.95%, 29/88) (P < 0.001), while ER expression was positive 19.44% (14/72) in EMPD and only 9.09% (8/88) in MPD (P = 0.059). ER-AR expression pattern was significantly different between MPD (3.41%, 3/88) and EMPD (16.67%, 12/72) (P < 0.001). No difference of AR (P = 0.301) or ER (P = 0.239) expression was identified between invasive (48.57%, 51/105 of AR, and 11.43%, 12/105 of ER) and noninvasive PD. In MPD, no difference of AR expression between MPD alone (7/18, 38.89%) and MPD with underling ductal carcinoma of breast (22/70, 31.43%) was identified (P = 0.548). In EMPD, expression of AR was 63.33% (38/60) in penoscrotal EMPD. Our current results indicate that MPD and EMPD presented different expression pattern of AR and ER and would help to further identify the molecular subtype of MPD and EMPD for adjuvant hormonal therapy, especially for patients with penoscrotal EMPD.

佩吉特病（PD）是一种罕见的上皮内腺癌，由乳腺佩吉特病（MPD）和乳腺外佩吉特病（EMPD）组成。目前，已发表的文献中关于类固醇激素受体在MPD和EMPD中表达模式的数据很少。 采用免疫组织化学染色和H评分法对88例MPD和72例EMPD中的雌激素受体（ER）和雄激素受体（AR）的表达进行了评估。 AR的阳性表达在EMPD中（61.11%，44/72）显著高于MPD（32.95%，29/88）（P < 0.001），而ER表达在EMPD中为19.44%（14/72），在MPD中仅为9.09%（8/88）（P = 0.059）。ER - AR表达模式在MPD（3.41%，3/88）和EMPD（16.67%，12/72）之间有显著差异（P < 0.001）。在浸润性PD（AR为48.57%，51/105；ER为11.43%，12/105）和非浸润性PD之间，未发现AR（P = 0.301）或ER（P = 0.239）表达的差异。在MPD中，单纯MPD（7/18，38.89%）与伴有乳腺导管癌的MPD（22/70，31.43%）之间AR表达无差异（P = 0.548）。在EMPD中，阴囊阴茎部位的EMPD中AR表达为63.33%（38/60）。 我们目前的研究结果表明，MPD和EMPD呈现出不同的AR和ER表达模式，这将有助于进一步确定MPD和EMPD的分子亚型，以便进行辅助激素治疗，尤其是对于阴囊阴茎部位的EMPD患者。