{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T05:43:44Z","timestamp":1793684624641,"version":"4.5.1"},"reference-count":32,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T00:00:00Z","timestamp":1619568000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","award":["Fondi Ricerca Corrente - L3P2"],"award-info":[{"award-number":["Fondi Ricerca Corrente - L3P2"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The diagnosis of cystic echinococcosis (CE) is primarily based on imaging, while serology should be applied when imaging is inconclusive. CE cyst stage has been reported among the most important factors influencing the outcome of serodiagnosis. We performed a systematic review and meta-analysis of the relation between cyst stage of hepatic CE and diagnostic sensitivity of serological tests, to evaluate whether their relation is a consistent finding and provide guidance for the interpretation of results of serological tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methodology\/Principal findings<\/jats:title>\n                    <jats:p>\n                      MEDLINE, EMBASE, CENTRAL, and Lilacs databases were searched on December 1\n                      <jats:sup>st<\/jats:sup>\n                      2019. Original studies published after 2003 (year of publication of the CE cyst classification), reporting sensitivity of serological tests applied to the diagnosis of human hepatic CE, as diagnosed and staged by imaging, were included. The quality of studies was assessed using the Newcastle-Ottawa Scale. Data from 14 studies were included in the meta-analysis. Summary estimates of sensitivities and 95% confidence intervals were obtained using random effects meta-analysis. Overall, test sensitivity was highest in the presence of CE2 and CE3 (CE3a and\/or CE3b), and lowest in the presence of CE5 and CE4 cysts. ELISA, ICT and WB showed the highest sensitivities, while IHA performed worst.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Conclusions\/Significance<\/jats:title>\n                    <jats:p>The results of our study confirm the presence of a clear and consistent relation between cyst stage and serological tests results. Limitations of evidence included the heterogeneity of the antigenic preparations used, which prevented to determine whether the relation between cyst stage and sensitivity was influenced by the type of antigenic preparation, the paucity of studies testing the same panel of sera with different assays, and the lack of studies assessing the performance of the same assay in both field and hospital-based settings. Our results indicate the absolute need to consider cyst staging when evaluating serological results of patients with hepatic CE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0009370","type":"journal-article","created":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T14:01:39Z","timestamp":1619618499000},"page":"e0009370","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":84,"title":["Serology for the diagnosis of human hepatic cystic echinococcosis and its relation with cyst staging: A systematic review of the literature with meta-analysis"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0478-3914","authenticated-orcid":true,"given":"Francesca","family":"Tamarozzi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2852-2287","authenticated-orcid":true,"given":"Ronaldo","family":"Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2832-9241","authenticated-orcid":true,"given":"Veronica Andrea","family":"Fittipaldo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0108-6822","authenticated-orcid":true,"given":"Dora","family":"Buonfrate","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Gottstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar","family":"Siles-Lucas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,4,28]]},"reference":[{"key":"pntd.0009370.ref001","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/bs.apar.2016.07.001","article-title":"Biology and systematics of Echinococcus","volume":"95","author":"RC Thompson","year":"2017","journal-title":"Adv Parasitol"},{"key":"pntd.0009370.ref002","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/bs.apar.2016.11.002","article-title":"Ecology and life cycle patterns of Echinococcus species","volume":"95","author":"T Romig","year":"2017","journal-title":"Adv Parasitol"},{"key":"pntd.0009370.ref003","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/bs.apar.2016.09.006","article-title":"The echinococcoses: diagnosis, clinical management and burden of disease","volume":"96","author":"P Kern","year":"2017","journal-title":"Adv Parasitol."},{"key":"pntd.0009370.ref004","doi-asserted-by":"crossref","first-page":"296","DOI":"10.3201\/eid1202.050499","article-title":"Global socioeconomic impact of cystic echinococcosis","volume":"12","author":"CM Budke","year":"2006","journal-title":"Emerg Infect Dis."},{"key":"pntd.0009370.ref005","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/bs.apar.2016.11.001","article-title":"Global distribution of alveolar and cystic echinococcosis","volume":"95","author":"P Deplazes","year":"2017","journal-title":"Adv Parasitol"},{"key":"pntd.0009370.ref006","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.pt.2008.12.008","article-title":"Echinococcosis: diagnosis and diagnostic interpretation in population studies","volume":"25","author":"PR Torgerson","year":"2009","journal-title":"Trends Parasitol"},{"key":"pntd.0009370.ref007","volume-title":"Ending the neglect to attain the Sustainable Development Goals: a road map for neglected tropical diseases 2021\u20132030","author":"World health Organization","year":"2020"},{"key":"pntd.0009370.ref008","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.actatropica.2009.11.001","article-title":"Writing Panel for the WHO-IWGE. 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