| Paget ’s disease (PD) was firstly reported by the British physicist surgery JamesPaget in1874. PD usually occurs in patients from40to60years old and prone tobetide on the nipple,areola and areas are rich with apocrine. Mammary Paget ’s disease(MPD) occurred in the nipple and areola of the breast, and which occurred in othersareas is called extramammary Paget’s disease (EPD). The skin lesions of PD ischaracterized by circumscribed red patches, exudation on the surface, crusting orkeratinizing scale, and the lesions would expand to the surrounding gradually. It mayinvade into surroundings after a few months or years, or even develop to ulcers.Thepatients may be interrupted by the varying degrees of conscious itching or pain for someof them.There is a lot of controversy exist in the pathogenesis and tissue sources of the PD. The immunohistochemical techniques is used for continuously in-depth research on thepathogenesis and tissue sources of the PD with more achievement. The vast majority ofscholars believe that the MPD occurrence have great relevance with the development ofbreast cancer. It is thought that MPD may be transferred by the epidermis of themammary adenocarcinoma in situ. EPD has some relevance with the malignant tumorsin colon, rectum, anus and the organ surrounding or invasived. As for this paper, byusing the immune markers about MUC5AC (Gastric mucin M1, gastric mucin antigen),OPN (Osteopontin,OPN) and Caveolin-1(caveolin-1),we studied and discussed itsmeaning expressed in MPD and EPD, and expect to further clarify the tissue of origin ofthe MPD and EPD.ObjectiveBy studying MUC5AC, OPN and Caveolin-1in MPD and EPD expression, weare going to investigate the origin of histology and significance in MPD and EPD.MethodThe pathologic tissue paraffin blocks of26cases of PD patients (13cases of MDPand EDP each) and5cases of normal tissue paraffin blocks,which are previouslydiagnosed, have been carried out by immunohistochemical staining,comparing theexpression of the three Antibodies about MUC5AC, OPN and Caveolin-1in the MPDand EPD.Result1.The expression state of MUC5AC: The expression of MUC5AC in thecytoplasm of normal epidermis is weakly positive with the rate of60%; Theexpression of MUC5AC in the cytoplasm of PD is strong expressed with the rate of30.77%, positive expressed with the rate of26.92%, weakly positive expressed withthe rate of30.77%; The expression of MUC5AC in the cytoplasm of EPD is strongexpressed with the rate of46.15%, positive expressed with the rate of23.08%,weakly positive expressed with the rate of23.08%; The expression of MUC5AC in thecytoplasm of MPD is strong expressed with the rate of15.38%, positive expressedwith the rate of30.77%, weakly positive expressed with the rate of38.46%. MUC5AC is strong positive expressed in the in the cytoplasm of EPD with therate of46.15%, while the rate of strong positive expressed in the MPD is15.38%,suggesting that the rate of strong positive expressed of the MUC5AC in the EPD issignificantly higher than that in the MPD; The rate of positive expressed in EPD is23.08%, while The rate in the MPD is30.77%, suggesting that the rate of positiveexpressed of the MUC5AC in the EPD is slightly higher than that in the EPD; The rateof weakly expressed in EPD is23.08%, while The rate in the MPD is38.46%,suggesting that the rate of weakly positive expressed of the MUC5AC in the MPD isslightly higher than that in the EPD. In a word, the expression rate of MUC5AC in theEPD is higher than MPD. The statistical results show that P is equal to0.121,and p>0.05. so,none significant deviation is existed between the expression of MUC5AC inthe EPD and the MPD.2. The OPN is strong positive expressed with the rate of20%and the positive rateof40%in the cytoplasm of normal epidermis; The expression of OPN in the cytoplasmof PD is strong expressed with the rate of15.39%, positive expressed with the rate of26.92%, weakly positive expressed with the rate of50%; The expression of OPN in thecytoplasm of EPD is strong expressed with the rate of23.08%, positive expressed withthe rate of38.46%, weakly positive expressed with the rate of38.46%; The expressionof OPN in the cytoplasm of MPD, is strong expressed with the rate of7.69%, positiveexpressed with the rate of15.38%, weakly positive expressed with the rate of69.23%.OPN is strong positive expressed in the in the cytoplasm of EPD with the rate of23.08%,while The rate in the MPD is7.69%, suggesting that the rate of strong positiveexpressed of the OPN in the EPD is significantly higher than that in the MPD; The rateof positive expressed in EPD is38.46%, while The rate in the MPD is15.38%,suggesting that the rate of positive expressed of the OPN in the EPD is higher than thatin the EPD; The rate of weakly expressed in EPD is38.46%, while The rate in theMPD is69.23%, suggesting that the rate of weakly positive expressed of the OPN inthe MPD is slightly higher than that in the EPD. In short, the expression rate of OPN ishigher than MPD. The statistical results show that P is equal to0.045,and p<0.05, so The expression of OPN in the EPD and in the MPD exist significant deviation.3. Caveolin-1is weakly positive expressed with the rate of100%in normal skincell membrane/cytoplasm. The expression of Caveolin-1in PD membrane/cytoplasmis strong expressed with the rate of15.39%, positive expressed with the rate of50%,weakly positive expressed with the rate of26.92%.Caveolin-1in EPD membrane/cytoplasm is positive and weakly positive expressed with the rate of61.54%and30.77%respectively. The expression of Caveolin-1in membrane/cytoplasm of MPD,is strong expressed with the rate of30.77%, positive expressed with the rate of38.46%,weakly positive expressed with the rate of23.08%.As for Caveolin-1,there is no strong expression in the EPD, but the rate of strongexpressed in the MPD is30.77%,indicating that that the rate of strong positiveexpressed of the Caveolin-1in the MPD is significantly higher than that in the EPD; Ina word, The expression of Caveolin-1in the MPD is significantly higher than that in theEPD. The statistical results show that P is equal to0.222,and p>0.05, There is of nosignificant deviation between the expression of Caveolin-1in the EPD and in the MPD.Conclution1. None significant deviation is existed between the expression of MUC5AC in theEPD and the MPD;2. The expression of OPN in the EPD and in the MPD is of significant deviation(P=0.045，P <0.05);3. There is of no significant deviation between the expression of Caveolin-1in theEPD and in the MPD. |
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