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目的：探讨Ｃａ１５３ 在Ｐａｇｅｔ 病鉴别诊断中的价值。方法：对１１ 例阴囊Ｐａｇｅｔ 病回顾性地做Ｃａ１５３、ＥＭＡ、ＣＥＡ和ＨＭＢ４５ 免疫组化染色，并以４ 例Ｂｏｗｅｎ 病和１ 例恶性黑色素瘤做对照。结果：Ｃａ１５３ 、ＥＭＡ 在Ｐａｇｅｔ 病和大、小汗腺及皮脂腺均有较强的表达，４ 例Ｂｏｗｅｎ 病均无Ｃａ１５３ 表达，但其中２ 例有ＥＭＡ 表达。ＣＥＡ 在６ 例（５４．５ ％）Ｐａｇｅｔ 病中有表达。ＨＭＢ４５ 只在恶性黑色素瘤中表达。结论：Ｃａ１５３ 在Ｐａｇｅｔ 细胞的相对特异性表达提示它可作为Ｐａｇｅｔ 病与Ｂｏｗｅｎ 病鉴别诊断的标志物，其对诊断的敏感性与ＥＭＡ 相同，但特异性高于ＥＭＡ。同时还说明Ｐａｇｅｔ 病的发生可能与汗腺有关。
Objective: To explore the value of Ca15 3 in the differential diagnosis of Paget’s disease. Methods: 11 cases of Paget’s disease of the scrotum were retrospectively stained with Ca15 3, EMA, CEA and HMB45 immunohistochemistry, and 4 cases of Bowen’s disease and 1 case of malignant melanoma were used as controls. Results: Ca153 and EMA were strongly expressed in Paget′s disease, large and small sweat glands and sebaceous glands, and none of the 4 cases had Ca153 expression in Bowen’s disease, but 2 of them had EMA expression. CEA was expressed in 6 cases (54.5%) of Paget’s disease. HMB45 is only expressed in malignant melanoma. Conclusion: The relative specific expression of Ca15 3 in Paget cells suggests that it can be used as a marker for the differential diagnosis of Paget’s disease and Bowen’s disease. Its sensitivity to diagnosis is the same as that of EMA, but its specificity is higher than that of EMA. It also shows that the occurrence of Paget’s disease may be related to sweat glands.