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Positive KI67 and Periodic Acid-Schiff Mandates Wider Range of Excision in Scrotal Extramammary Paget's Disease


  • The authors have indicated no significant interest with commercial supporters.

Address correspondence and reprint requests to: Hui Wen, MD, Department of Urology, Huashan Hospital, Fudan University, 12 Central Urumqi Rd., Shanghai 200040, PR China, or email:



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.


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).


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 (= .05). The incidence of positive margins was significantly higher in the double-positive group than in the double-negative group (= .03).


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

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