WHO classification of alveolar echinococcosis: Principles and application
WHO classification of alveolar echinococcosis: Principles and application
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DOI：
10.1016/j.parint.2005.11.041
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发表时间：
2006-01-01
影响因子：
1.9
通讯作者：
Bresson-Hadni, S
中科院分区：
文献类型：
--
作者：
Kern, P;Wen, H;Bresson-Hadni, S
泡状棘球绦虫病是由狐狸绦虫幼虫期(多房棘球绦虫)引起的，常被诊断为肝脏占位性病变。其生长模式类似于恶性肿瘤，浸透整个肝脏，扩散到邻近器官，并在远处器官形成转移。因此，最常见的鉴别诊断之一是肝癌。在肝癌肿瘤-结节-转移(TNM)系统的指导下，欧洲泡型包虫病协调监测网络和世卫组织泡型包虫病非正式工作组提出了泡型包虫病的临床分类。命名为PNM系统(P=肝内寄生性肿块，N=邻近器官受累，M=转移)。对于肿瘤学的TNM，将单一的PNM分类分为四个阶段，I到IV。该系统是通过对来自两个治疗中心(法国贝桑松和德国乌尔姆)的97例患者的回顾分析而开发的。最近，世界卫生组织将这一分类应用于世界各地4个临床中心的222名患者(法国贝桑松26例；乌鲁木齐/中国46例；日本札幌58例；德国乌尔姆92例)。所有患者均可归类为1998年1月至2005年6月期间确诊的患者。分期分组显示了中心的差异，但似乎根据不同的治疗方案将患者分开。世界卫生组织的分类不仅是疾病表现的国际标准化的工具，也有助于评估欧洲和亚洲不同治疗中心选定的诊断和治疗程序的结果。(C)2005爱思唯尔爱尔兰有限公司。保留所有权利。
Alveolar echinococcosis is caused by the larval stage of the fox tapeworm (Echinococcus multilocularis) and is frequently diagnosed as a space occupying lesion in the liver. The growth pattern resembles that of a malignant tumor with infiltration throughout the liver, spreading into neighbouring organs and metastases formation in distant organs. Thus, one of the prevailing differential diagnoses is liver cancer. Guided by the Tumor-Node-Metastasis (TNM) system of liver cancer, the European Network for Concerted Surveillance of Alveolar Echinococcosis and the WHO Informal Working Group on Echinococcosis proposed a clinical classification for alveolar echinococcosis. It was designated as PNM system (P=parasitic mass in the liver, N=involvement of neighbouring organs, and M=metastasis). As for TNM in oncology, single PNM categories were combined into four stages, I to IV The system was developed by a retrospective analysis of 97 patients' records from two treatment centers (Besancon/France and Ulm/Germany). Recently, this WHO classification was applied to 222 patients in 4 clinical centers around the world (Besancon/France, n=26;Urumqi/China, n=46; Sapporo/Japan, n=58; and Ulm/Germany, n=92). All patients could be classified who had been diagnosed in the period from January 1998 to June 2005. The stage grouping indicated center differences, but appeared to segregate patients according to various treatment regimens. The WHO classification not only serves as a tool for the international standardization of disease manifestation but also aids to evaluate the outcome of a chosen diagnostic and treatment procedure in different treatment centers in Europe and Asia. (C) 2005 Elsevier Ireland Ltd. All rights reserved.