Positive KI67 and periodic acid-schiff mandates wider range of excision in scrotal extramammary Paget's disease

Dermatol Surg. 2013 Mar;39(3 Pt 1):381-6. doi: 10.1111/dsu.12080. Epub 2012 Dec 26.

Abstract

Background: Extramammary Paget's disease (EMPD) of the scrotum is a rare disease that requires surgical excision. A positive margin is related to recurrence and poorer prognosis. We aimed to investigate the expression of Ki67 and periodic acid-Schiff (PAS) in a biopsy sample and to evaluate their predictive value in true margin status.

Methods: Sixty-four patients with noninvasive scrotal EMPD were included. Immunohistochemical staining of Ki67 and PAS was reviewed and compared statistically with the margin status of intraoperative frozen section examination (FSE).

Results: Seventeen of 64 patients had a positive margin discovered at the first FSE. Expression of Ki67 was not significantly different between positive and negative margin status (p = .16). Expression of PAS was higher in samples with positive margins (p = .05). The incidence of positive margins was significantly higher in the double-positive group than in the double-negative group (p = .03).

Conclusion: Positive expression of both factors in a biopsy sample requires wider excision to ensure negative margins.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / analysis*
  • Frozen Sections
  • Genital Neoplasms, Male / surgery*
  • Humans
  • Immunohistochemistry
  • Ki-67 Antigen / analysis*
  • Male
  • Middle Aged
  • Paget Disease, Extramammary / surgery*
  • Periodic Acid-Schiff Reaction*
  • Scrotum*

Substances

  • Biomarkers, Tumor
  • Ki-67 Antigen