抗-recEm18 抗体水平的轨迹决定了肝泡型包虫病根治性切除术后的随访。

The trajectory of anti-recEm18 antibody levels determines follow-up after curative resection of hepatic alveolar echinococcosis.

机构信息

Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Department of Internal Medicine III, Division of Infectious Diseases, University Hospital of Ulm, Ulm, Germany.

出版信息

HPB (Oxford). 2024 Feb;26(2):224-233. doi: 10.1016/j.hpb.2023.10.007. Epub 2023 Oct 10.

DOI:10.1016/j.hpb.2023.10.007

PMID:37867084

Abstract

INTRODUCTION

Recurrence after curative resection of hepatic alveolar echinococcosis remains a clinical challenge. The current study tested if assessment of anti-recEm18 allows for postsurgical patient surveillance.

METHODS

A retrospective study with patients undergoing liver resection for alveolar echinococcosis (n = 88) at the University Hospital Bern from 2002 to 2020 and at the University Hospital and Medical Center Ulm from 2011 to 2017 was performed. Analysis was directed to determine a potential association of pre- and postoperative values of anti-recEm18 with clinical outcomes.

RESULTS

Anti-recEm18 had a linear correlation to the maximum lesion diameter (R = 0.558). Three trajectories of anti-recEm18 were identified based on a threshold of 10 AU/ml: "Em18-low" (n = 31), "responders" (n = 53) and "residual disease" (n = 4). The decline of anti-recEm18 in "responders" reached a plateau after 10.9 months at which levels decreased by 90%. The only patient with recurrence in the entire population was also the only patient with a secondary increase of anti-recEm18.

CONCLUSION

In patients with preoperative elevated values, anti-recEm18 confirms curative surgery at 12 months follow-up and allows for long-term surveillance.

摘要

介绍

肝泡型包虫病（alveolar echinococcosis，AE）根治性切除术后的复发仍然是一个临床挑战。本研究旨在检验抗 recEm18 评估是否可用于术后患者监测。

方法

对 2002 年至 2020 年在伯尔尼大学医院和 2011 年至 2017 年在乌尔姆大学医院和医疗中心接受肝切除术治疗 AE 的患者进行回顾性研究（n=88）。分析旨在确定术前和术后抗 recEm18 值与临床结局之间的潜在关联。

结果

抗 recEm18 与最大病变直径呈线性相关（R=0.558）。根据 10 AU/ml 的阈值，确定了抗 recEm18 的三种轨迹：“Em18-低”（n=31）、“应答者”（n=53）和“残留疾病”（n=4）。“应答者”的抗 recEm18 下降在 10.9 个月后达到平台，水平下降 90%。在整个研究人群中唯一复发的患者也是唯一抗 recEm18 二次升高的患者。