Alveococcosis in humans is characterized by a tumor-like growth with a tendency to infiltration of neighbouring organs or metastases formation in the lungs and brain. The study aimed to improve on the clinical evaluation of patients with alveolar echinococcosis (AE) and to determine the risk of metacestode spreading to adjacent tissues or distant organs by a detection of adhesion molecules involved in the tumorigenesis process. Serum concentrations of sPECAM-1, sVCAM-1 and sE-selectin adhesion molecules were studied in 8 AE patients in comparison to 75 cases with malignant neoplasms, including cases with tumors of hepatic and extra-hepatic location. The adhesion molecules were found to be early predictive markers of the active, tissue infiltrated alveococcosis with the risk of parasite spreading through the circulation. High serum levels of soluble PECAM-1 molecule were strongly related to the advanced, progressive disease and the fatality of patients' clinical prognosis.
[Show abstract][Hide abstract] ABSTRACT: Alveolar echinococcosis (AE) caused by Echinococcus multilocularis infections is a dangerous old disease in the Northern Hemisphere. The aim of the paper was to collect and analyze data on human AE in Poland in the last two decades.
The sources of data were both the cases officially registered and detected by an active field and laboratory surveillance. The cases were verified by clinical, epidemiological, and laboratory criteria. Altogether 121 human cases of AE were detected. Among these 83 (68,6%) cases were classified as confirmed, 16 as probable and 22 as possible. During the two decades a continuous increase in detection rate was noticed. The cases were 6-82 years old at the time of diagnosis (mean - 47.7 years). Sex ratio M/F was 0.86/1.0. The AE was fatal in 23 (19%) patients (mean age at death - 54.1 years). Family agglomeration of AE was found in 4 foci, involving 9 patients. Seventy six of the cases were diagnosed in an advanced stage of disease. In all cases the liver was the primary location of AE. In 30 (24.8%) patients a spread to other organs was observed. Ninety four of the patients were treated with albendazole. In 73 (60%) patients a surgical operation was performed, including 15 liver transplantations.
The studies confirmed that AE is an emerging disease in Poland, which is the fourth country in Europe with over 120 cases detected. The results also indicate the need of a wider national programme for implementation of screening in the highest AE risk areas (north-eastern Poland) with an effort to increase the public awareness of the possibility of contracting E. multilocularis, and above all, training of the primary care physicians in the recognition of the risk of AE to allow for an early detection of this dangerous disease.
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