Fujimoto Yoshinori, Ito Akira, Ishikawa Yuji, Inoue Mitsutaka, Suzuki Yasuaki, Ohhira Masumi, Ohtake Takaaki, Kohgo Yutaka
Third Department of Internal Medicine, 2-1 Midorigaoka-Higashi, Asahikawa 078-8510, Japan.
J Gastroenterol. 2005 Apr;40(4):426-31. doi: 10.1007/s00535-004-1559-7.
Alveolar echinococcosis (AE) is a rare parasitic disease caused by Echinococcus multicularis and most commonly involves the liver. Early diagnosis is essential to improve the prognosis of patients with AE of the liver. Em18, an 18-kD diagnostic antigen from Echinococcus multilocularis, is highly specific and sensitive to detect AE. We previously reported that an enzyme-linked immunosorbent assay (ELISA) system using a recombinant Em18 antigen (RecEm18) was highly useful in the differential serodiagnosis of AE. In this report, we present seven AE patients who showed dynamic changes in RecEm18-ELISA values in the course of long-term follow up of albendazole (ABZ) chemotherapy, and/or resections of the liver or bone metastasis. All seven AE patients revealed positive values, over the cutoff level, of the RecEm18-ELISA before the treatments. The values in six patients fell below the cutoff level after the treatments, but the value in a patient with recurrence never fell below the cutoff level, and increased again. From these results, it seems that the RecEm18-ELISA is useful to evaluate the efficacy of treatment and predict recurrence in patients with AE. RecEm18-ELISA may be an important examination for: (a) the mass screening of AE in Japan, (b) the confirmative diagnosis of AE prior to surgical and/or chemotherapeutic treatments, (c) the follow up of AE patients after treatments, and (d) for deciding on the discontinuation of chemotherapy in patients with an appropriate response.
肺泡型棘球蚴病（AE）是一种由多房棘球绦虫引起的罕见寄生虫病，最常累及肝脏。早期诊断对于改善肝AE患者的预后至关重要。Em18是一种来自多房棘球绦虫的18-kD诊断抗原，对检测AE具有高度特异性和敏感性。我们之前报道过，使用重组Em18抗原（RecEm18）的酶联免疫吸附测定（ELISA）系统在AE的鉴别血清诊断中非常有用。在本报告中，我们介绍了7例AE患者，他们在阿苯达唑（ABZ）化疗、肝切除或骨转移的长期随访过程中，RecEm18-ELISA值出现了动态变化。所有7例AE患者在治疗前RecEm18-ELISA值均高于临界值呈阳性。6例患者治疗后的值降至临界值以下，但1例复发患者的值从未降至临界值以下，且再次升高。从这些结果来看，RecEm18-ELISA似乎有助于评估AE患者的治疗效果并预测复发。RecEm18-ELISA可能是一项重要检查，用于：（a）日本AE的大规模筛查；（b）手术和/或化疗治疗前AE的确证诊断；（c）AE患者治疗后的随访；（d）确定化疗反应良好患者化疗的停药时机。
