Cross-sectional analysis of distribution characteristics of lesion subtypes in cases of echinococcosis
Objective To investigate the distribution of the subtypes,location,and number of lesion in echinococcosis cases in China,so as to provide a theoretical basis for the diagnosis,prevention,and management of echinococcosis.Methods Cases with complete information on lesion types based on images obtained in the 2012-2016 epidemiological survey of echinococcosis in China were selected for descriptive analysis of lesion subtype distribution.Regression analysis was performed to determine the relationship between the number of lesions in each subtype and the number of cases in the corresponding subtype.Results Among the 4 014 cases included in the study,there were no significant differences between male and female patients in the proportions of cystic and alveolar echinococcosis cases in each subtype of lesion(all P>0.005).For cystic echinococcosis cases,there were significant differences in the proportion of cases among different provinces of each subtype(χ2=58.803～534.097,all P<0.05),and there were significant differences in the proportion of cases among different occupations except for type III(subtype CL,Ⅱ,Ⅳ,Ⅴ:P<0.05 by Fisher's exact probability test;subtypeⅠ:χ2=104.534,P<0.001).For alveolar echinococcosis cases,there were significant differences in the proportion of cases among different provinces of each subtype,i.e.,infiltrative,colliquative and cavitary,calcification(all P<0.05 by Fisher's exact probability test),and there were significant differences in the proportion of cases among different occupation of each subtype(Fisher's exact probability test:P<0.001;P=0.009;P<0.001).Colliquative and cavitary subtype with cystic lesion as well as cystic and calcified type with alveolar lesion were not found in cases with both cystic and alveolar lesions.The proportions of cystic lesions in different stages decreased significantly in turn in Sichuan Province(Z=-2.630,P=0.009)and Xinjiang Uygur Autonomous Region(Z=-2.254,P=0.024).Not less than 90.92%of the lesions of all subtypes of cystic echinococcosis cases were located in the liver.Regression analysis showed a significant negative exponential relationship between the number of lesions of each subtype and the number of cases with the corresponding subtype lesion(all P<0.05).Conclusions There are regional and occupational characteristics in the subtype of lesions in echincoccosis cases in China,and the lesions are mainly located in the liver.The cross-sectional analysis of lesion classification can be used as an important supplement to the traditional epidemiological analysis and provide an important theoretical basis for the control,prevention,and treatment of echinococcosis.
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