Research On The Applying Aminolevulinic Acid Determining The Surgery Resection Boundary Of Primary Extramammary Paget’s Disease

Objective To explore the feasibility of applying photosensitizer Aminolevulinic Acid (ALA)to determine the tumor boundary of the primary extramammary paget’s disease, to guide the surgery resection.Methods During the period of October 2014 to April 2015, randomly divided the patients which were diagnosed the primary extramammary paget’s disease by pathological biopsy and Immunohistochemistry into A and B group. Treat the erosion and exudation symptoms with 3% boric acid lotion and lactic acid ethacridine calamine lotion. In group A, directly drop the 20% ALA solution on the borderline ranging the tumor lesions than 2cm with the naked eye, cover and protect it from light more than three hours. Before surgery, shine the blue light on the tumor lesions, determine the border of fluorescence, enlarge the fluorescence border 2cm as the Surgical margin. Pathological biopsy monitor the surgery resection margin. In the group B, under the naked eyes, expand 2cm resection along the lesion border. Both groups, pathology biopsy monitor the cutting edge.Results 1.Secondary infection does not affect the judgment of lesion area and boundaries.2. Preoperative application of 20% ALA determineing extramammary paget’s disease tumor boundary can effectively achive the 2cm wide surgical margin tumor-free.Conclusion Extramammary paget disease misdiagnosed rate is high. Long-term no healing of the middle-aged scrotal eczema, should be considered about extramammary paget’s disease. Although the oozing, erosion often result in secondary infection of Staphylococcus aureus, does not affect the judgment of the tumor boundaries. Fluorescence of ALA can be effectively used to determine the lesion area and boundaries of extramammary paget’s disease before Surgery, and prevent the influence of subjective factors on the determination of tumor boundaries, and have the clinical reference value.