title: Metastatic and prognostic factors in patients with alveolar echinococcosis.
abstract: BACKGROUND
  Prognostic predictions in alveolar echinococcosis (AE) are usually based on relapse and metastasis. Thus, assessment of factors associated with metastasis and clinical outcomes in patients with alveolar echinococcosis are of significant important. The purpose of this study was to investigate the correlated factors for metastasis and prognosis for patients with AE.
  
  
  METHODS
  We analyzed 159 AE patients who underwent curative surgery at the First Teaching Hospital of Xinjiang Medical University from February 2003 to December 2013 by hematoxylin and eosin (HE) staining. Immunohistochemistry (IHC) staining for CD44 was performed in 159 AE and adjacent normal liver specimens. The clinicopathological parameters were analyzed for metastasis and prognosis, including gender, age, size, calcification, necrosis, foreign body granuloma and CD44 protein level.
  
  
  RESULTS
  The rate of metastasis was 22.1%. Chi-square test showed that low levels of CD44 was associated with metastasis (P = 0.004). However, multivariate analysis suggested that CD44 expression is not independent prognostic indicators for overall survival (P = 0.356). In addition, no correlations between prognosis and gender, age, size, calcification, necrosis, foreign body granulomatous, metastasis were identified.
  
  
  CONCLUSIONS
  The finding that a low level of CD44 is associated with metastasis in AE patients. At present, it thus remains question whether CD44 expression is a valid prognostic marker for AE, further investigations are required.
authors.affiliation: Department of Pathology, First Teaching Hospital of Xinjiang Medical University Xinjiang, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Pathology, First Teaching Hospital of Xinjiang Medical University Xinjiang, China.
authors.forename: Chang
authors.initials: C
authors.lastname: Lu
authors.affiliation: Department of Pathology, First Teaching Hospital of Xinjiang Medical University Xinjiang, China.
authors.forename: Xia
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Pathology, First Teaching Hospital of Xinjiang Medical University Xinjiang, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D018450:Disease Progression; D015536:Down-Regulation; D004443:Echinococcosis; D004444:Echinococcosis, Hepatic / Q000276:immunology* / Q000469:parasitology / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D018960:Hyaluronan Receptors / Q000032:analysis*; D007150:Immunohistochemistry; D008168:Lung / Q000276:immunology* / Q000469:parasitology / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers; C497483:CD44 protein, human; D018960:Hyaluronan Receptors
keywords: CD44; alveolar echinococcosis; metastasis; prognosis