[Clinical significance of serological diagnosis with ELISA and Western blotting in alveolar echinococcosis of the liver].

Alveolar Echinococcosis of the Liver (AEL) usually progresses to a fatal outcome, because of invasion to adjacent structures and distant metastasis. Therefore, it is necessary to establish a diagnostic method for early detection of AEL and post-operative surveillance. Serological tests with enzyme-linked immunosorbent assay (ELISA) and Western-blotting (WB) had been carried out mainly in our mass screening, but the clinical significance of immuno-diagnosis has not been clarified adequately. The present study described the results of the screening carried out from 1986 to 1994 and also investigated the sero-reactivity and the changes of immune response in 81 patients and the 1,244 people excluded from screening. 42 cases (3%) out of 2,084 sero-positive people screened with ELISA were diagnosed with AEL. Western-blotting was tested at the same time in 845 of the excluded people, and positive results were observed in 172 (20%). On the other hand, ELISA showed positive results in 67 (87%) out of 77 patients with AEL including non-screened cases. WB showed abnormal sero-reactivity in 52 (96%) out of 54 patients, with 48 testing positive and 4 pseudo-positive. The changes of the immune response after operation were evaluated by operative curability. In all cases with palliative operations, both ELISA and WB remained positive. However, in 14 out of 18 cases with complete resections, immune activity converted to being negative within 2 or 3 years. The results revealed that combined sero-diagnosis with ELISA and WB is useful for early diagnosis of AEL and the follow-up of patients after operation.