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

• Published in: HPB (Oxford, England) Vol. 26; no. 2; pp. 224 - 233
• Main Authors: Gloor, Severin, Jiang, Wanjie, Maurer, Martin H, Gottstein, Bruno, Oberli, Alexander, Hagemann, Jürgen B, Hotz, Julian F, Candinas, Daniel, Lachenmayer, Anja, Grüner, Beate, Beldi, Guido
• Format: Journal Article
• Language: English
• Published: England 01-02-2024
• Subjects: Echinococcosis - surgery; Echinococcosis, Hepatic - surgery; Follow-Up Studies; Hepatectomy - adverse effects; Humans; Retrospective Studies
• ISSN: 1365-182X; 1477-2574; 1477-2574
• DOI: 10.1016/j.hpb.2023.10.007

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