目的探讨阴茎阴囊Paget病的临床特点、治疗方法及疗效。方法阴茎阴囊Paget病患者130例,年龄51～90岁,平均71岁。病程6个月～16年,平均4年。主要临床表现为阴囊、会阴部皮肤瘙痒、红斑、糜烂、渗液,可见局部皮肤表面粗糙、皮损逐渐扩大,稍隆起,有时呈菜花状。Ray分期标准,A1期41例,A2期69例,B期20例。130例均行手术治疗,切除肉眼所见病变区域,切缘距病灶边缘2 cm,深度达深筋膜,快速冰冻切片检查,肿瘤细胞累及切缘者13例(10．0％),即予以扩大切除范围。3例术后病理证实累及切缘,立即再手术治疗。5例经病理证实腹股沟淋巴结转移者行单侧或双侧腹股沟淋巴结清扫术。结果130例均经病理学检查确诊。切口Ⅰ期愈合94例,Ⅱ期愈合16例,切口感染20例,均经换药或植皮后治愈。术后81例获随访,随访时间1～10年,平均3年。8例(9．9％)术后8个月～5年出现局部复发,其中6例复发灶位于原手术切口,1例位于远离切口位置的残余阴囊皮肤,1例于术后1年发现腹股沟淋巴结肿大,病理证实为转移,均再次手术治疗后痊愈。死亡5例(6．2％),死亡原因为Paget病远处转移,包括全身转移3例,肺转移1例,脑转移1例。结论对阴囊皮损的可疑Paget病患者应尽早行组织学活检,确诊后行病灶根治性切除术。彻底切除病变组织是预防复发的关键,预后良好。 Objective To investigate the clinical features, treatment and efficacy of penis scrotum Paget disease. Methods Penile scrotum Paget disease in 130 patients, aged 51 to 90 years, mean 71 years. Course of 6 months to 16 years, an average of 4 years. The main clinical manifestations of the scrotum, peritoneal skin itching, erythema, erosion, exudate, showing rough surface of local skin, skin lesions gradually expanded, slightly elevated, and sometimes cauliflower-like. Ray staging criteria, 41 cases in stage A1, 69 cases in stage A2 and 20 cases in stage B. All 130 cases underwent surgical resection and excision of the lesion seen by the naked eye. The margin was 2 cm from the edge of the lesion, deep fascia was covered, and rapid frozen section examination was performed. Thirteen (10.0%) of the tumor cells involved the margins, Expand the scope of resection. Three cases of pathology confirmed the involvement of margins, and then surgery. 5 cases of pathologically confirmed inguinal lymph node metastasis were unilateral or bilateral inguinal lymphadenectomy. Results 130 cases were diagnosed by pathological examination. There were 94 cases of primary incision healed, 16 cases of secondary incision, 20 incisional wounds, all of which were cured by dressing change or skin grafting. 81 patients were followed up for 1 to 10 years with an average of 3 years. Eight patients (9.9%) had local recurrence 8 months to 5 years after operation. Among them, 6 cases of recurrent lesions were located in the original surgical incision, 1 case of residual scrotal skin located far away from the incision and 1 case of groin after 1 year Lymphadenopathy, pathology confirmed as metastasis, were cured again after surgery. 5 died (6.2%). The cause of death was distant metastasis Paget disease, including 3 cases of systemic metastasis, 1 case of lung metastasis and 1 case of brain metastasis. Conclusions The suspicious Paget disease of the scrotal skin lesions should undergo biopsy as soon as possible and the radical resection of the lesions should be performed after diagnosis. Complete removal of diseased tissue is the key to prevent recurrence, the prognosis is good.