乳房Paget病的相关研究进展

Research Progress of Paget Disease of Breast

摘要: 近年来，乳腺癌的发病率居高不下，其中乳房Paget病(Mammary Paget disease, MPD)为一种相对罕见的乳腺癌。MPD是一种以乳头鳞状上皮内出现恶性腺上皮细胞(佩吉特细胞)为特征的乳腺癌，可能累及乳晕和邻近的皮肤，通常和乳房深部的癌相关。MPD根据有无乳房深部恶性病变，可分为3种类型：(1) 乳头乳晕区湿疹样改变合并乳腺浸润性癌成分(约56%)；(2) 乳头乳晕区的湿疹样改变合并导管内癌(约32%)；(3) 不伴有任何乳腺深部病灶的单纯乳头乳晕区湿疹样改变(约12%)。因目前MPD发病机制尚不完全清楚、最佳手术治疗的共识仍然存在争议以及综合治疗指南很少，所以MPD也逐渐引起了诸多学者的关注。因此，在本文中，我们将讨论MPD的发病机制以及治疗方案，为临床更好地诊治MPD提供依据。

Abstract: In recent years, the incidence of breast cancer has remained high, among which Mammary Paget disease (MPD) is a relatively rare breast cancer. MPD is a type of breast cancer characterized by the presence of malignant glandular epithelial cells (Paget cells) within the papillary squamous epithelium, which may involve the areola and adjacent skin, and is usually associated with deep breast cancer. According to the presence or absence of deep breast malignant lesions, MPD could be divided into three types: (1) eczema-like changes in the nipple areola combined with breast invasive carcinoma components (about 56%); (2) eczema-like changes in the nipple areola combined with intraductal carcinoma (about 32%); (3) Simple eczema-like changes in the nipple areola region without any deep breast lesions (about 12%). At present, the pathogenesis of MPD is not fully understood, the consensus of the best surgical treatment is still controversial, and the comprehensive treatment guidelines are few, so MPD has gradually attracted the attention of many scholars. Therefore, in this paper, we will discuss the pathogenesis and treatment of MPD, so as to provide a basis for better clinical diagnosis and treatment of MPD.