Preliminary study of reasonable and feasible safe distance for radical resection of hepatic alveolar echinococcosis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YANG Lingpeng ^1,2 , QIU Yiwen ¹ , YANG Xianwei ¹ , SHEN Shu ¹ ,  WANG Wentao ¹

1. Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. Department of Hepatobiliary and Pancreatic Surgery, The Second People’s Hospital of Yunnan Province, Kunming 650032, P. R. China;

Corresponding author：

WANG Wentao, Email: wwt02@163.com

Keywords：

hepatic alveolar echinococcosis; safe distance; radical resection

DOI：

10.7507/1007-9424.202201034

Video：

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Objective To explore the reasonable and feasible safe distance for radical resection of hepatic alveolar echinococcosis (HAE). Methods Liver samples were collected prospectively from 20 HAE patients (from Jan. 2019 to Jun. 2019) undergoing liver resection in West China Hospital of Sichuan University. A total of three samples containing lesion and adjacent liver tissue were collected from each patient, which were divided into lesion group, 0 to0.5 cm liver tissue group (contained 0.5 cm), 0.5 to 1.0 cm liver tissue group (contained 1.0 cm), 1.0 to 1.5 cm liver tissue group (contained 1.5 cm), and 1.5 to 2.0 cm liver tissue group (contained 2.0 cm). Comparisons of the Cox1 expressionand the liver fibrosis area between HAE lesion and adjacent liver tissues were performed. Results Both expression of Cox1 and fibrosis area in HAE lesion were significantly higher than those in the adjacent liver tissues (P<0.000 1). However, there was no significant difference among the four kinds of adjacent liver tissues (P>0.05). There was a significant positive correlation between the expression of Cox1 and the fibrosis area both in HAE lesion and adjacent liver tissues (P<0.05). Conclusions Both the expression of Cox1 and degree of the liver fibrosis are significant higher in HAE lesion comparing to adjacent liver tissues, however, no significant difference is found among adjacent liver tissues. Consequently, a safe distance of 0.5 cm may be reasonable and feasible on the basis of the criteria for sample collection in the study.

Citation： YANG Lingpeng, QIU Yiwen, YANG Xianwei, SHEN Shu, WANG Wentao. Preliminary study of reasonable and feasible safe distance for radical resection of hepatic alveolar echinococcosis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(4): 512-516. doi: 10.7507/1007-9424.202201034 Copy

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1. Vuitton D. Alveolar echinococcosis of the liver: a parasitic disease in search of a treatment. Hepatology, 1990, 12(3 Pt 1): 617-618.
2. Brunetti E, Kern P, Vuitton DA, et al. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop, 2010, 114(1): 1-16.
3. Kern P, Wen H, Sato N, et al. WHO classification of alveolar echinococcosis: principles and application. Parasitol Int, 2006, 55 Suppl: S283-S287. doi: 10.1016/j.parint.2005.11.041.
4. Buttenschoen K, Carli Buttenschoen D, Gruener B, et al. Long-term experience on surgical treatment of alveolar echinococcosis. Langenbecks Arch Surg, 2009, 394(4): 689-698.
5. Kawamura N, Kamiyama T, Sato N, et al. Long-term results of hepatectomy for patients with alveolar echinococcosis: a single-center experience. J Am Coll Surg, 2011, 212(5): 804-812.
6. Shang J, Zhang G, Yu W, et al. Molecular characterization of human echinococcosis in Sichuan, Western China. Acta Trop, 2019, 190: 45-51.
7. Ma J, Wang H, Lin G, et al. Molecular identification of Echinococcus species from eastern and southern Qinghai, China, based on the mitochondrial cox1 gene. Parasitol Res, 2012, 111(1): 179-184.
8. Liu CN, Lou ZZ, Li L, et al. Discrimination between E. granulosus sensu stricto, E. multilocularis and E. shiquicus using a multiplex PCR assay. PLoS Negl Trop Dis, 2015, 9(9): e0004084. doi: 10.1371/journal.pntd.0004084.
9. Vuitton DA. The ambiguous role of immunity in echinococcosis: protection of the host or of the parasite? Acta Trop, 2003, 85(2): 119-132.
10. Gottstein B, Wang J, Blagosklonov O, et al. Echinococcus metacestode: in search of viability markers. Parasite, 2014, 21: 63. doi: 10.1051/parasite/2014063.
11. 温浩. 肝包虫病诊断和手术治疗新进展. 中华消化外科杂志, 2011, 10(4): 290-292.
12. Uchino J, Sato N, Nakajima Y, et al. Alveolar echinococcosis of the liver. Hokkaido University Press, Sapporo: Japan, 1993: 137-149.
13. Baraquin A, Hervouet E, Richou C, et al. Circulating cell-free DNA in patients with alveolar echinococcosis. Mol Biochem Parasitol, 2018, 222: 14-20.
14. Thierry AR, El Messaoudi S, Gahan PB, et al. Origins, structures, and functions of circulating DNA in oncology. Cancer Metastasis Rev, 2016, 35(3): 347-376.
15. Ancarola ME, Marcilla A, Herz M, et al. Cestode parasites release extracellular vesicles with microRNAs and immunodiagnostic protein cargo. Int J Parasitol, 2017, 47(10-11): 675-686.
16. Horai Y, Kakimoto T, Takemoto K, et al. Quantitative analysis of histopathological findings using image processing software. J Toxicol Pathol, 2017, 30(4): 351-358.
17. 阳丹才让, 宋戈, 张灵强, 等. Ⅰ、Ⅲ型胶原蛋白在肝泡型包虫病患者肝组织中的表达及意义. 中国普外基础与临床杂志, 2016, 23(10): 1209-1213.
18. Wang J, Zhang C, Wei X, et al. TGF-β and TGF-β/Smad signaling in the interactions between Echinococcus multilocularis and its hosts. PLoS One, 2013, 8(2): e55379. doi: 10.1371/journal.pone.0055379.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Preliminary study of reasonable and feasible safe distance for radical resection of hepatic alveolar echinococcosis

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