Analysis Of Clinical Prognostic Factors Of Extramammary Paget's Disease

Background and ObjectiveExtramammary Paget's disease(EMPD)is a rare low-grade malignant tumor of slow growth,which is more common in the middle-aged and the elderly in vulva,crissum,axillary and other apocrine sweat glands distributed rich areas,such as the complex and varied clinical manifestations is not typical,early performance is erythema,oozy,pruritus,etc.,and more advanced can appear nodular debaucjed ulcer,etc.,due to its clinical manifestation is eczema,therefore,this disease also known as eczema carcinoma,relatively neglected the misdiagnosis and delayed treatment.There are relatively few literatures at home and abroad on such lesions,the clinicians lack of full understanding of the clinical pathologic features and the biological behavior of this disease,therefore,the purpose of this study is to analyze the clinicopathological features of EMPD and the effect of different surgical methods and different pathological features on the prognosis of patients,and to provide clinical reference for the clinical diagnosis and treatment of EMPD.MethodsA retrospective analysis of 55 patients who were diagnosed by pathological examination as extramammary Paget's disease and successfully followed up by The First Affiliated Hospital of Zhengzhou University from January 2013 to March 2019.The data of clinical data were statistically analyzed by software,and the factors influencing the clinical prognosis of extramammary Paget's disease were statistically analyzed by chi-square test.P<0.05 as a standard to screen out the factors affecting the clinical prognosis of extramammary Paget's disease.Results1.From January 2013 to March 2019,65 patients with EMPD were selected from the First Affiliated Hospital of Zhengzhou University.And the follow-up rate was 84.6%.The patients with the shortest follow-up time were 9 months,and the longest were 84 months.There were 43 males and 12 females.and the ratio of male to female is 3.58:1;The youngest patients were 46 years old,the oldest were 86 years old,including 44 patients over 60 years old and 11 patients under 60 years old,and the ratio among age groups was 3.82:1;The patients with the shortest time from onset to visit were 8 months,and the longest were as long as 16 years,among which the patients with the time from onset to visit more than 2 years accounted for 58.2%.2.A statistical analysis of the nine factors that may affect the clinical prognosis of extramammary Peget's disease found that the seven indexes were not statistically significant:sex,age,time of onset,site of onset,degree of lesion invasion,extent of lesions,and mode of surgical repair.There was statistical significance in the two indexes of whether the intraoperative frozen pathological examination was performed(P=0.003)and whether there was lymph node metastasis(P=0).i.e.Conclusions1.The recurrence rate of patients undergoing rapid frozen pathology examination is lower.Through rapid frozen pathology examination,we can make clear the nature of the lesion,the cut edge and the basal edge of the lesion,and ensure the complete resection of the lesion,thus reducing the recurrence rate.2.Whether there is lymph node metastasis is an important factor affecting postoperative recurrence of extramammary Paget disease.Once there is lymph node metastasis,postoperative recurrence is more likely and the prognosis is poor.3.There was no significant correlation between gender,age,lesion site,time of arrival,mode of repair,lesion range and degree of lesion invasion.