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Pérez JC, Salgado AC, Pérez-Mies B, Rullán JAD, Ajuria-Illarramendi O, Alia EMG, Serrano Domingo JJ. Extramammary Paget Disease: a Therapeutic Challenge, for a Rare Entity. Curr Oncol Rep 2023; 25:1081-1094. [PMID: 37421583 PMCID: PMC10556167 DOI: 10.1007/s11912-023-01434-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2023] [Indexed: 07/10/2023]
Abstract
PURPOSE OF REVIEW Extramammary Paget disease (EMPD) is a rare entity which is more frequently localized at the vulva, though it only accounts for 1-2% of vulvar neoplasms. It is a primary cutaneous adenocarcinoma whose cell of origin is still a matter of controversy: it can either arise from apocrine/eccrine glands or from stem cells. The diagnosis demands a biopsy and entails a histopathological analysis by which cells show similar characteristics as breast Paget disease. RECENT FINDINGS Treatment approach can entail surgery, radiotherapy, photodynamic therapy, systemic chemotherapy, and topical chemotherapy. For metastatic disease, many different chemotherapy regimens have been explored and even targeted therapy can play an important role in this disease. Since almost 30-40% of patients overexpress HER-2, trastuzumab and anti-HER-2 therapies can be employed in this setting. Due to its low incidence, there is almost no specific evidence on therapeutic interventions for this disease. Thus, there is a neat unmet need for molecular characterization of EMPD and diagnostic tools that allow clinicians to guide treatment both in the early and in the advanced disease settings. In this review, we aim to summarize available evidence about diagnosis and treatment of EMPD, both localized and metastatic, and to provide a comprehensive analysis that may help clinicians for therapeutic decisions.
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Affiliation(s)
- Jesús Chamorro Pérez
- Medical Oncology Department, Ramón y Cajal University Hospital, Carretera de Colmenar Viejo, Km 9.100, 28034 Madrid, CP Spain
| | - Alfonso Cortes Salgado
- Medical Oncology Department, Ramón y Cajal University Hospital, Carretera de Colmenar Viejo, Km 9.100, 28034 Madrid, CP Spain
| | - Belén Pérez-Mies
- Pathology Department, Ramón y Cajal University Hospital, Carretera de Colmenar Viejo, Km 9.100, 28034 Madrid, CP Spain
| | - Jose Antonio Domínguez Rullán
- Radiation Oncology Department, Ramón y Cajal University Hospital, Carretera de Colmenar Viejo, Km 9.100, 28034 Madrid, CP Spain
| | - Odile Ajuria-Illarramendi
- Nuclear Medicine Department, Ramón y Cajal University Hospital, Carretera de Colmenar Viejo, Km 9.100, 28034 Madrid, CP Spain
| | - Eva María Guerra Alia
- Medical Oncology Department, Ramón y Cajal University Hospital, Carretera de Colmenar Viejo, Km 9.100, 28034 Madrid, CP Spain
| | - Juan José Serrano Domingo
- Medical Oncology Department, Ramón y Cajal University Hospital, Carretera de Colmenar Viejo, Km 9.100, 28034 Madrid, CP Spain
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Wu Y, Sun S, Huang Y, Xiao M, Zhao X, Lu X, Xia B, Qiao K, Zhang S, Wu Q, Xiong J, Cheng S, Song Y. Correlation analysis between androgen receptor and the clinicopathological features and prognosis of mammary Paget's disease. J Cancer Res Clin Oncol 2023; 149:1175-1184. [PMID: 35364707 DOI: 10.1007/s00432-022-03988-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 03/17/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE Little is known about the prognostic value of androgen receptor (AR) status in mammary Paget's disease (MPD). The purpose of this study was to explore AR status and the distribution of molecular subtypes in MPD as well as the relationship between AR expression and clinicopathological factors and to evaluate its prognostic value. METHODS We analyzed 170 MPD patients of varying subtypes. AR expression was verified by immunohistochemical staining, and the correlations between AR expression and clinicopathological characteristics and survival status were analyzed. We further investigated 91 MPD patients with invasive ductal carcinoma (MPD-IDC). RESULTS AR was expressed in 55.3% of overall MPD patients, and 78.2% had the human epidermal growth factor receptor 2 (HER2) overexpression subtype. AR positivity was significantly correlated with BMI (P = 0.037) and pathological N stage (P = 0.023). Multivariate analysis indicated that pathological T stage and pathological N stage were independent prognostic factors for overall survival (OS). The positive AR group was significantly associated with better OS (P = 0.014). Among 91 MPD-IDC patients, AR was expressed in 56.0%, and 80.0% had the HER2 overexpression subtype. AR positivity was significantly correlated with pathological N stage (P = 0.033). Multivariate analysis indicated that AR and pathological T stage were independent prognostic factors for OS. Furthermore, AR positivity was significantly related to better OS (P = 0.005) in MPD-IDC patients as well as in patients with the HER2 overexpression subtype (P = 0.029). CONCLUSION Our results confirmed that AR is a potential biomarker for evaluating the prognosis of patients.
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Affiliation(s)
- Yang Wu
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, 150 Haping Road, Nangang District, Harbin, 150081, China
| | - Shanshan Sun
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, 150 Haping Road, Nangang District, Harbin, 150081, China
| | - Yuanxi Huang
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, 150 Haping Road, Nangang District, Harbin, 150081, China
| | - Min Xiao
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, 150 Haping Road, Nangang District, Harbin, 150081, China
| | - Xuhai Zhao
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, 150 Haping Road, Nangang District, Harbin, 150081, China
| | - Xiangshi Lu
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, 150 Haping Road, Nangang District, Harbin, 150081, China
| | - Bingshu Xia
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, 150 Haping Road, Nangang District, Harbin, 150081, China
| | - Kun Qiao
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, 150 Haping Road, Nangang District, Harbin, 150081, China
| | - Shiyuan Zhang
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, 150 Haping Road, Nangang District, Harbin, 150081, China
| | - Qiqi Wu
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, 150 Haping Road, Nangang District, Harbin, 150081, China
| | - Jing Xiong
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, 150 Haping Road, Nangang District, Harbin, 150081, China
| | - Shaoqiang Cheng
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, 150 Haping Road, Nangang District, Harbin, 150081, China.
| | - Yanni Song
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, 150 Haping Road, Nangang District, Harbin, 150081, China.
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Rao Y, Zhu J, Zheng H, Ren Y, Ji T. Cell origin and genome profile difference of penoscrotum invasive extramammary Paget disease compared with its in situ counterpart. Front Oncol 2022; 12:972047. [PMID: 36091120 PMCID: PMC9451029 DOI: 10.3389/fonc.2022.972047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
Penoscrotum extramammary Paget disease (pEMPD) is a rare cutaneous carcinoma with an unknown cell origin. pEMPD always presents as a tumor in situ with an indolent process, whereas some progress into invasive forms with more aggressive behavior. The in situ and invasive cases display different morphologies and biological behavior, and thus far, a relationship between these two components has not been demonstrated. Immunohistochemistry was used to disclose the immunotype of pEMPD, and the results revealed that invasive/in situ pEMPD possessed with some identical immunophenotypes such as CK7, P63, and CK10, which inferred the clonal relatedness. The variable expressions of GCDFP-15 and carcino embryonic antigen hinted that tumor cell origin might be an epidermal sweat gland in epiderma. In our cohort, invasive pEMPD presented increased expression of androgen receptor and decreased MUC5CA expression, and these two changes might bring to the shift of invasive phenotype. To better understanding the relationship between these distinct tumor forms, we performed whole exome sequencing testing to evaluate overlapping genomic alterations of six paired invasive/in situ pEMPDs. The results showed that missense mutation was the predominant mutation type, and C>T transition accounted for 65.1% in all SNP mutation. Among the top 20 differential genes obtained from the six paired invasive/in situ pEMPD analysis, MUC4 (one missense, one in frame del, and one multi-hit), AHNAK2 (two missense and one multi-hit), DOT1L (two missense and one multi-hit), and FRG1 (two missense and one-multi hit) mutations were most enriched in invasive pEMPDs, which postulated that these genes may play roles in the disease progression.
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Affiliation(s)
- Yamin Rao
- Department of Pathology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jinchao Zhu
- Department of Pathology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haiyan Zheng
- Department of Pathology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yong Ren
- Department of Pathology, General Hospital of Central Theater Command of the Chinese People’s Liberation Army (PLA), Wuhan, China
- *Correspondence: Tianhai Ji, ; Yong Ren,
| | - Tianhai Ji
- Department of Pathology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Tianhai Ji, ; Yong Ren,
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Takahashi GW, Vetto J, Leitenberger JJ, Hung A. Efficacy of Abemaciclib in the Management of Refractory Metastatic Extramammary Paget’s Disease. Cureus 2022; 14:e27534. [PMID: 36060324 PMCID: PMC9428388 DOI: 10.7759/cureus.27534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2022] [Indexed: 11/25/2022] Open
Abstract
Published systemic therapy options for metastatic extramammary Paget's disease have largely been anecdotal due to the rarity of this disease, which has precluded the ability to conduct clinical trials. We describe the favorable response of a 72-year-old man with extramammary Paget's disease, whose disease has been controlled with the CDK4/6 inhibitor, abemaciclib. The rationale behind the selection of this therapy is discussed.
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Noor F, Saleem MH, Chen JT, Javed MR, Al-Megrin WA, Aslam S. Integrative bioinformatics approaches to map key biological markers and therapeutic drugs in Extramammary Paget's disease of the scrotum. PLoS One 2021; 16:e0254678. [PMID: 34292991 PMCID: PMC8297842 DOI: 10.1371/journal.pone.0254678] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 06/30/2021] [Indexed: 12/16/2022] Open
Abstract
Extramammary Paget’s disease (EMPD) is an intra-epidermal adenocarcinoma. Till now, the mechanisms underlying the pathogenesis of scrotal EMPD is poorly known. This present study aims to explore the knowledge of molecular mechanism of scrotal EMPD by identifying the hub genes and candidate drugs using integrated bioinformatics approaches. Firstly, the microarray datasets (GSE117285) were downloaded from the GEO database and then analyzed using GEO2R in order to obtain differentially expressed genes (DEGs). Moreover, hub genes were identified on the basis of their degree of connectivity using Cytohubba plugin of cytoscape tool. Finally, GEPIA and DGIdb were used for the survival analysis and selection of therapeutic candidates, respectively. A total of 786 DEGs were identified, of which 10 genes were considered as hub genes on the basis of the highest degree of connectivity. After the survival analysis of ten hub genes, a total of 5 genes were found to be altered in EMPD patients. Furthermore, 14 drugs of CHEK1, CCNA2, and CDK1 were found to have therapeutic potential against EMPD. This study updates the information and yields a new perspective in the context of understanding the pathogenesis of EMPD. In future, hub genes and candidate drugs might be capable of improving the personalized detection and therapies for EMPD.
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Affiliation(s)
- Fatima Noor
- Department of Bioinformatics and Biotechnology, Government College University, Faisalabad, Pakistan
| | | | - Jen-Tsung Chen
- Department of Life Sciences, National University of Kaohsiung, Kaohsiung, Taiwan
| | - Muhammad Rizwan Javed
- Department of Bioinformatics and Biotechnology, Government College University, Faisalabad, Pakistan
| | - Wafa Abdullah Al-Megrin
- Biology Department, Faculty of Science, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Sidra Aslam
- Department of Bioinformatics and Biotechnology, Government College University, Faisalabad, Pakistan
- * E-mail:
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Barrutia L, Martínez-García G, Santamarina-Albertos A, Garabito Solovera EL, Volo V, Ruíz-Sánchez D, Manchado López P. Differentiating pagetoid Bowen disease from Paget disease on the nipple-areola complex: Two unique, challenging cases. J Cutan Pathol 2021; 48:1416-1422. [PMID: 34164837 DOI: 10.1111/cup.14092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 06/01/2021] [Accepted: 06/08/2021] [Indexed: 11/29/2022]
Abstract
Pagetoid Bowen disease is a subtype of Bowen disease that accounts for 5% of Bowen disease. It is extremely rare for Bowen disease to appear on the nipple-areola complex, with only seven cases described in the previous literature. Of those seven cases, only one was of the pagetoid subtype. We report two cases of pagetoid Bowen disease on this location, one of them being the first case of pagetoid Bowen disease affecting the nipple reported to date. On this location, it is crucial to perform a meticulous differential diagnosis to rule out Paget disease, because of its contrasting therapeutic and prognostic implications. In order to do this, clinical and histopathological aspects must be considered. From a clinical point of view, previous literature has stated that nipple involvement can be a clue that points to Paget disease. However, one of our cases shows that this is not always true. Regarding histopathological analysis, a complete excision of the tumor might be necessary to observe clear features of Bowen disease, such as full-thickness atypia of the epidermis and intercellular bridges. An immunohistochemical panel comprising carcinoembryonic antigen, gross cystic disease fluid protein, epithelial membrane antigen, p63, CK34betaE12, periodic acid-Schiff, estrogen receptor, and progesterone receptor can be decisive in complicated cases.
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Affiliation(s)
- Leire Barrutia
- Dermatology Department, Clinical University Hospital of Valladolid, Valladolid, Spain
| | | | | | | | - Víctor Volo
- Dermatology Department, Clinical University Hospital of Valladolid, Valladolid, Spain
| | - Daniel Ruíz-Sánchez
- Dermatology Department, Clinical University Hospital of Valladolid, Valladolid, Spain
| | - Pilar Manchado López
- Dermatology Department, Clinical University Hospital of Valladolid, Valladolid, Spain
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7
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Rathore R, Yadav D, Agarwal S, Dudani P, Verma KK, Mathur SR. Primary Extra Mammary Paget's Disease of Vulva, With Apocrine Adenocarcinoma, Signet Ring Cell Differentiation and Distant Metastasis. J Family Reprod Health 2020; 14:276-280. [PMID: 34055001 PMCID: PMC8144487 DOI: 10.18502/jfrh.v14i4.5213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective: Extramammary Paget's disease (EMPD) with invasive carcinoma and distant metastasis is extremely rare. In vulva EMPD associated apocrine carcinoma with signet ring cell differentiation has not been described in the literature so far. Its slow evolution, varied clinical presentation and histological appearances, lead to difficulty in diagnosis of this disease. Case report: We hereby report a case of primary EMPD with invasive carcinoma and distant metastasis in a 59-year-old female who presented with erythematous indurated plaque over vulva. Histopathology revealed Paget cell infiltration throughout the epidermis with invasive carcinoma in dermis and liver metastasis on CECT. The immunohistochemical expressions of CK7, CK20, GCDFP-15, CEA, p40, CDX 2, Her-2/ neu, AR, ER, were examined to explicate the cellular differentiation of this carcinoma. According to the histological assessment, this case was diagnosed as primary EMPD with apocrine adenocarcinoma, signet ring cell differentiation, vulva. Conclusion: Owing to poor prognosis, a high index of clinical suspicion along with histological and immunohistochemical assessment is of utmost importance in arriving at final diagnosis.
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Affiliation(s)
- Ruchi Rathore
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Deepika Yadav
- Department of Dermatology, All India Institute of Medical Sciences, New Delhi, India
| | - Shipra Agarwal
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Pankhuri Dudani
- Department of Dermatology, All India Institute of Medical Sciences, New Delhi, India
| | - Kaushal K Verma
- Department of Dermatology, All India Institute of Medical Sciences, New Delhi, India
| | - Sandeep R Mathur
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
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8
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Konstantinova AM, Kazakov DV. Extramammary Paget disease of the vulva. Semin Diagn Pathol 2020; 38:50687. [PMID: 32921571 DOI: 10.1053/j.semdp.2020.09.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 09/04/2020] [Indexed: 02/03/2023]
Abstract
Extramammary Paget disease (EMPD) is a rare neoplasm with uncertain histogenesis, usually presenting in the anogenital area, most commonly in the vulva. The disease is characterized by slow grow and high recurrence rates. This article reviews the epidemiological, clinical, morphological, genetic and treatment features of EMPD of the vulva reported in recent years.
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Affiliation(s)
- Anastasia M Konstantinova
- Department of Pathology, Clinical Research and Practical Center for Specialized Oncological care, Saint-Petersburg, Russian Federation; Department of Pathology, Medical Faculty, Saint-Petersburg State University, Russian Federation; Department of Pathology, Saint-Petersburg Medico-Social Institute, St.-Petersburg, Russian Federation
| | - Dmitry V Kazakov
- Sikl's Department of Pathology, Medical Faculty in Pilsen, Charles University in Prague, Pilsen, Czech Republic; Bioptical Laboratory, Pilsen, Czech Republic.
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9
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Gatalica Z, Vranic S, Krušlin B, Poorman K, Stafford P, Kacerovska D, Senarathne W, Florento E, Contreras E, Leary A, Choi A, In GK. Comparison of the biomarkers for targeted therapies in primary extra-mammary and mammary Paget's disease. Cancer Med 2020; 9:1441-1450. [PMID: 31899853 PMCID: PMC7013075 DOI: 10.1002/cam4.2820] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 12/20/2019] [Accepted: 12/20/2019] [Indexed: 12/14/2022] Open
Abstract
Background Primary Extra‐mammary Paget's disease (EMPD) is a very rare cutaneous adenocarcinoma affecting anogenital or axillary regions. It is characterized by a prolonged course with recurrences and eventually distant metastatic spread for which no specific therapy is known. Methods Eighteen EMPD (13 vulvar and five scrotal) and ten mammary Paget's disease (MPD) cases were comprehensively profiled for gene mutations, fusions and copy number alterations, and for therapy‐relevant protein biomarkers). Results Mutations in TP53 and PIK3CA were the most frequent in both cohorts: 7/15 and 5/15 in EMPD; 1/6 and 4/7 in MPD HER2 gene amplification was detected in 4/18 EMPD (3 vulvar and 1 scrotal case) in contrast to MPD where it was detected in the majority (7/8) of cases. TOP2A gene amplification was seen in 2/12 EMPD and 1/6 MPD, respectively. Similarly, no difference in estrogen receptor expression was seen between the EMPD (4/15) and MPD (3/10). Androgen receptor was also expressed in the majority of both cohorts (12/16 EMPD) and (7/8 MPD).Here ARv7 splice variant was detected in 1/7 EMPD and 1/4 MPD cases, respectively. PD‐L1 expression on immune cells was exclusively observed in three vulvar EMPD. In contrast to MPD, six EMPDs harbored a “high” tumor mutation burden (≥10 mutations/Mb). All tested cases from both cohorts were MSI stable. Conclusions EMPD shares some targetable biomarkers with its mammary counterpart (steroid receptors, PIK3CA signaling pathways, TOP2A amplification). HER2 positivity is notably lower in EMPD while biomarkers to immune checkpoint inhibitors (high TMB and PD‐L1) were observed in some EMPD. Given that no consistent molecular alteration characterizes EMPD, comprehensive theranostic profiling is required to identify individual patients with targetable molecular alterations.
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Affiliation(s)
| | - Semir Vranic
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Božo Krušlin
- Ljudevit Jurak Department of Pathology and Cytology, Clinical Hospital Center Sestre Milosrdnice, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | | | | | - Denisa Kacerovska
- Medical Faculty in Pilsen, Sikl's Department of Pathology, Charles University in Prague, Pilsen, Czech Republic.,Bioptical Laboratory, Pilsen, Czech Republic
| | | | | | | | | | - April Choi
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
| | - Gino K In
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
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10
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Chen S, Chen H, Yi Y, Jiang X, Lei H, Luo X, Chen Y, Liu S, Yuan D, Jia X, Li J. Comparative study of breast cancer with or without concomitant Paget disease: An analysis of the SEER database. Cancer Med 2019; 8:4043-4054. [PMID: 31134761 PMCID: PMC6639179 DOI: 10.1002/cam4.2242] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 04/15/2019] [Accepted: 04/26/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Most mammary Paget disease (MPD) is associated with underlying in situ or invasive breast cancer. The objective of this study was to compare the clinicopathological characteristics and survival outcomes between breast cancer with Paget disease (PD) and breast cancer alone. METHODS From the Surveillance, Epidemiology, and End Results (SEER) database, 2000-2015, of the US National Cancer Institute, we identified 1569 women who had PD with invasive ductal carcinoma (PD-IDC) and 1489 women who had PD with ductal carcinoma in situ (PD-DCIS). Independent demographic and clinicopathological variables as well as survival outcomes of these patients were compared to patients with the corresponding breast cancer without concomitant PD. RESULTS PD-IDC and PD-DCIS both had worse survival outcomes and poorer tumor characteristics than the corresponding disease without PD. Contrary to in the breast cancer alone groups, in the breast cancer with PD groups, the HR status (P = 0.182 in PD-IDC and P = 0.371 in PD-DCIS), HER2 status (P = 0.788 in PD-IDC and P = 0.643 in PD-DCIS), and combined molecular subtype (P = 0.196 in PD-IDC and P = 0.853 in PD-DCIS) were not found to affect disease prognosis. After matching tumor characteristics and treatment approaches, PD-IDC as well as PD-DCIS exhibited no significant difference in disease prognosis with corresponding IDC and DCIS. Finally, by comparative analysis, a kind of PD-DCIS (ICD-O-3 code 8543/3) showed many invasive behaviors (31.8% of 8543/3 patients had stage I-III cancer) and was associated with worse survival outcomes than the other type of PD-DCIS. CONCLUSIONS Breast cancer with concomitant PD was associated with more aggressive tumor characteristics and worse survival outcomes. The HR status, HER2 status, and combined molecular subtype could not affect the prognosis of breast cancer with PD. Moreover, a portion of the PD-DCIS cases were invasive breast cancer cases that required special treatment.
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Affiliation(s)
- Shijing Chen
- Department of Dermatology, People's Hospital of DeYang City, Deyang, China
| | - Huaquan Chen
- Department of Dermatology, People's Hospital of DeYang City, Deyang, China
| | - Ying Yi
- Department of Br, Surgery, People's Hospital of DeYang City, Deyang, China
| | - Xuemei Jiang
- Department of Br, Surgery, People's Hospital of DeYang City, Deyang, China
| | - Hai Lei
- Department of Br, Surgery, People's Hospital of DeYang City, Deyang, China
| | - Xue Luo
- Department of Br, Surgery, People's Hospital of DeYang City, Deyang, China
| | - Yu Chen
- Department of Br, Surgery, People's Hospital of DeYang City, Deyang, China
| | - Sha Liu
- Department of Br, Surgery, People's Hospital of DeYang City, Deyang, China
| | - Dan Yuan
- Department of Dermatology, People's Hospital of DeYang City, Deyang, China
| | - Xinjian Jia
- Department of Br, Surgery, People's Hospital of DeYang City, Deyang, China
| | - Junyan Li
- Department of Br, Surgery, People's Hospital of DeYang City, Deyang, China
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11
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Guo H, Qi RQ, Sheng J, Liu C, Ma H, Wang HX, Li JH, Gao XH, Wan YS, Chen HD. MiR-155, a potential serum marker of extramammary Paget's disease. BMC Cancer 2018; 18:1078. [PMID: 30458743 PMCID: PMC6247506 DOI: 10.1186/s12885-018-4994-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 10/24/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Extramammary Paget's disease (EMPD), a rare skin malignancy with non-specific manifestations, is often misdiagnosed as eczema of scrotum or tinea cruris. Although the diagnosis of EMPD could be confirmed by biopsy, it can be delayed as patients are reluctant to receive invasive operations. Herein, we investigated the serum miRNA expressions of EMPD patients and compared to that of the eczema of scrotum or tinea cruris patients as well as health volunteers for potential diagnostic markers for EMPD. METHODS Altogether 45 subjects including 16 patients diagnosed with EMPD, 12 patients diagnosed with eczema of scrotum or tinea cruris and 17 healthy volunteers were enrolled in this study. Serum from all of subjects were collected to identify miRNAs (by miRNA array global normalization, RT-PCR validation, and receiver operating characteristic curve analysis) that could be potential diagnostic markers for EMPD. RESULTS The miRNA array analyses revealed that the expressions of 37 miRNAs from the EMPD patients were different (change ≥4-fold) from health volunteers. Among these miRNAs, the expression of miR-155 was significantly increased (p < 0.01) in the EMPD patients as compared with that of the health volunteers and the eczema of scrotum or the tinea cruris patients (no difference between these two control groups). In addition, receiver operating characteristic (ROC) curve analysis showed that diagnostic capacities (defined as the area under curve of ROC) of miR-155 are 0.85 (as compared with health volunteers group) and 0.81 (as compared with the eczema of scrotum or the tinea cruris patients group), respectively. CONCLUSION The serum miRNA expression of gene miR-155 in the EMPD patients was differentiated from that of other subjects warranting further validation of miR-155 as a diagnostic marker of EMPD.
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Affiliation(s)
- Hao Guo
- Department of Dermatology, No.1 Hospital of China Medical University, 155N. Nanjing Street, Shenyang, 110001, People's Republic of China
| | - Rui-Qun Qi
- Department of Dermatology, No.1 Hospital of China Medical University, 155N. Nanjing Street, Shenyang, 110001, People's Republic of China
| | - Jie Sheng
- Department of Anesthesiology, No.1 Hospital of China Medical University, 155N. Nanjing Street, Shenyang, 110001, People's Republic of China
| | - Chang Liu
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, Kingston, RI, 02881, USA
| | - Hang Ma
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, Kingston, RI, 02881, USA
| | - He-Xiao Wang
- Department of Dermatology, No.1 Hospital of China Medical University, 155N. Nanjing Street, Shenyang, 110001, People's Republic of China
| | - Jiu-Hong Li
- Department of Dermatology, No.1 Hospital of China Medical University, 155N. Nanjing Street, Shenyang, 110001, People's Republic of China
| | - Xing-Hua Gao
- Department of Dermatology, No.1 Hospital of China Medical University, 155N. Nanjing Street, Shenyang, 110001, People's Republic of China
| | - Yin-Sheng Wan
- Department of Physiology, Providence College, Providence, RI, 02918, USA
| | - Hong-Duo Chen
- Department of Dermatology, No.1 Hospital of China Medical University, 155N. Nanjing Street, Shenyang, 110001, People's Republic of China.
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