title: Positive KI67 and periodic acid-schiff mandates wider range of excision in scrotal extramammary Paget's disease.
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).
  
  
  CONCLUSIONS
  Positive expression of both factors in a biopsy sample requires wider excision to ensure negative margins.
authors.affiliation: Department of Urology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Chen-Chen
authors.initials: CC
authors.lastname: Feng
authors.forename: Lu-Jia
authors.initials: LJ
authors.lastname: Wang
authors.forename: Zhong-Wen
authors.initials: ZW
authors.lastname: Zhou
authors.forename: Qiang
authors.initials: Q
authors.lastname: Ding
authors.forename: Zu-Jun
authors.initials: ZJ
authors.lastname: Fang
authors.forename: Guo-Wei
authors.initials: GW
authors.lastname: Xia
authors.forename: Hao-Wen
authors.initials: HW
authors.lastname: Jiang
authors.forename: Gang
authors.initials: G
authors.lastname: Xu
authors.forename: Hui
authors.initials: H
authors.lastname: Wen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D005629:Frozen Sections; D005834:Genital Neoplasms, Male / Q000601:surgery*; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D010145:Paget Disease, Extramammary / Q000601:surgery*; D010503:Periodic Acid-Schiff Reaction; D012611:Scrotum
chemical_list: D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen