文章：

乳腺佩吉特病影像学探析：洞见与展望

A Pictorial Exploration of Mammary Paget Disease: Insights and Perspectives

原文发布日期：3 November 2023

DOI: 10.3390/cancers15215276

类型: Article

开放获取: 是

英文摘要：

Mammary Paget disease (MPD) is a rare condition primarily affecting adult women, characterized by unilateral skin changes in the nipple–areolar complex (NAC) and frequently associated with underlying breast carcinoma. Histologically, MPD is identified by large intraepidermal epithelial cells (Paget cells) with distinct characteristics. Immunohistochemical profiles aid in distinguishing MPD from other skin conditions. Clinical evaluation and imaging techniques, including magnetic resonance imaging (MRI), are recommended if MPD is suspected, although definitive diagnosis always requires histological examination. This review delves into the historical context, epidemiology, pathogenesis, clinical manifestations, and diagnosis of MPD, emphasizing the need for early detection. The classification of MPD based on pathogenesis is explored, shedding light on its varied presentations. Treatment options, including mastectomy and breast-conserving surgery, are discussed with clear guidelines for different scenarios. Adjuvant therapies are considered, particularly in cases with underlying breast cancer. Prognostic factors are outlined, underlining the importance of early intervention. Looking to the future, emerging techniques, like liquid biopsy, new immunohistochemical and molecular markers, and artificial intelligence-based image analysis, hold the potential to transform MPD diagnosis and treatment. These innovations offer hope for early detection and improved patient care, though validation through large-scale clinical trials is needed.

摘要翻译： 

乳腺佩吉特病（MPD）是一种主要影响成年女性的罕见疾病，其特征为单侧乳头-乳晕复合体（NAC）的皮肤改变，并常与潜在的乳腺癌相关。组织学上，MPD可通过具有显著特征的大型表皮内上皮细胞（佩吉特细胞）来识别。免疫组化特征有助于区分MPD与其他皮肤疾病。若怀疑MPD，建议进行临床评估和影像学检查（包括磁共振成像），但确诊始终依赖于组织学检查。本文综述深入探讨了MPD的历史背景、流行病学、发病机制、临床表现及诊断，强调了早期发现的必要性。文章基于发病机制对MPD进行分类，揭示了其多样化的表现形式。文中讨论了包括乳房切除术和保乳手术在内的治疗方案，并为不同情况提供了明确指导。同时考虑了辅助治疗，特别是在伴有潜在乳腺癌的病例中。概述了预后因素，强调了早期干预的重要性。展望未来，液体活检、新型免疫组化和分子标志物以及基于人工智能的图像分析等新兴技术，有望改变MPD的诊断和治疗。这些创新为早期检测和改善患者护理带来了希望，但仍需通过大规模临床试验进行验证。

原文链接：

A Pictorial Exploration of Mammary Paget Disease: Insights and Perspectives