Em2-ELISA for the follow-up of alveolar echinococcosis after complete surgical resection of liver lesions.

Alveolar echinococcosis, a serious and often fatal human disease, can be efficiently cured only by complete surgical resection of the Echinococcus multilocularis lesion. The present study showed that the determination in patients who had undergone surgery of antibody activity directed against the antigen Em2 reliably reflected complete or incomplete surgical resection. From 9 patients with pre-operative positive results in the Em2 enzyme-linked immunosorbent assay (Em2-ELISA) and successful surgical resection, 6 converted to negative within one year and the remaining 3 patients within 4 years after surgery. Six of 7 additional patients who showed recurrences in an average of 6 years after surgery despite assumed complete surgical resection, were positive by Em2-ELISA at the time of recurrence. Discrimination was not possible between these 2 groups of patients when using an ELISA employing crude antigen obtained from E. granulosus hydatid cyst fluid.