RESUMEN
Background The recurrence rate of extramammary Paget disease after surgical resection is high due to the lesions' poorly delineated and unclear margins. Aims To evaluate the impact of non-invasive tumour margin detection via photodynamic diagnosis plus reflectance confocal microscopy on the surgical outcomes of patients with extramammary Paget disease. Methods Thirty-six patients with histopathologically confirmed primary extramammary Paget disease between January 2017 and June 2018 were included in this study. The skin lesion margins were preoperatively observed using the naked eye, photodynamic diagnosis, and reflectance confocal microscopy. An incision was made 0.5-2 cm from the outermost non-invasive detection marker line. The incision depth was more significant than the follicle level or the deepest level affected by the tumour in the biopsy specimens. After the skin lesions were removed, a pathological examination of the specimens was conducted to ensure clear margins to prevent tumour recurrence and metastases. Results A total of 166 good-quality tissue sections were selected from 36 patients. The tumour surfaces and deep margins were within the scope of resection. Six patients (6/36, 15.4%) experienced local recurrence 2-12 months postoperatively. One patient (1/36, 2.8%) had lymph node metastasis without local recurrence 36 months postoperatively and died 50 months postoperatively (1/36, 2.8%). Limitations This study is limited by the small patient population, especially the number of patients with mucous membrane involvement. Conclusion Using photodynamic diagnosis plus reflectance confocal microscopy to detect the margins of extramammary Paget disease lesions non-invasively reduces the postoperative tumour recurrence rate and is a valuable guide for tumour treatment.
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The potential effects of Komagataeibacter hansenii CGMCC 3917 cells on alcohol-induced liver injury and their probable mechanisms were investigated. Male Kunming mice were orally administered with alcohol (10 mL per kg BW) alone or in combination with administration of K. hansenii CGMCC 3917 cells at 2 × 108 and 2 × 106 CFUs for 10 weeks. Administration of strain CGMCC 3917 cells, especially high dose administration, decreased the liver weights, fat gain, and fatty-acid metabolism-related enzyme SCD-1, ACC and FAS expressions and endotoxin release, which were elevated by alcohol treatment. Furthermore, the total contents of long chain fatty acids of the liver and serum in alcohol-treated mice supplemented with a high dose of strain CGMCC 3917 cells were decreased to 5.44 ± 0.19 µg mL-1 and 3.66 ± 0.15 µg mL-1 from 6.65 ± 0.31 µg mL-1 and 4.52 ± 0.21 µg mL-1, respectively. Conversely, the SCFAs decreased by ethanol treatment, particularly the acetic acid, propionic acid and butyric acid, were obviously enhanced in the faeces, colon and cecum of the mice supplemented with strain CGMCC 3917 cells. Moreover, strain CGMCC 3917 cells could regulate gut microbiome by significantly decreasing the abundance of Actinobacteria, Proteobacteria and Firmicutes, and dramatically increasing the abundance of Bacteroidetes in alcohol-treated mice. These findings suggest that K. hansenii CGMCC 3917 cells alleviate alcohol-induced liver damage via regulating fatty acid metabolism and intestinal microbiota diversity in mice.