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Predictors of Concomitant Pulmonary Involvement in Hepatic Cystic Echinococcosis: A Clinical Risk Stratification
Oğuzhan Taş1, Mehmet Ali Eryazğan2
1Department of General Surgery, Faculty of Medicine, Aksaray Training and Research Hospital, Aksaray University, Aksaray, Turkey. oguzhantas@hotmail.com.
Acta Parasitologica
|May 2, 2026
Summary
Hepatopulmonary hydatidosis (HPH) is linked to active liver cysts. A new HepatoMAP score using cyst activity and location can help identify patients needing thoracic imaging, reducing unnecessary tests.
Area of Science:
- Hepatology
- Parasitology
- Radiology
Background:
- Hepatopulmonary hydatidosis (HPH), a complication of hepatic cystic echinococcosis (CE), presents diagnostic challenges.
- Identifying patients at risk for HPH is crucial to avoid unnecessary thoracic imaging.
Purpose of the Study:
- To identify hepatic predictors of concomitant pulmonary involvement in CE patients.
- To develop a risk stratification model (HepatoMAP) for selective thoracic imaging in HPH.
Main Methods:
- Retrospective cohort study of 292 hepatic CE patients.
- Cyst activity (WHO staging) and anatomical distribution were assessed.
- Multivariable logistic regression and ROC analysis were used to develop and validate the HepatoMAP score.
Main Results:
- HPH was diagnosed in 7.8% of patients.
- Active cysts (WHO CE1-2) were the sole independent predictor of HPH (p < 0.001).
- The HepatoMAP score showed good discrimination (AUC 0.83) and calibration, with HPH predominantly in scores ≥3 and absent in scores 0-1.
Conclusions:
- Cyst activity is strongly associated with HPH in hepatic CE.
- The HepatoMAP score demonstrates potential for ruling out HPH, guiding selective thoracic imaging.
- Prospective validation is needed before clinical implementation.
Keywords:
Cystic echinococcosisHepatopulmonary hydatidosisRisk stratificationSegmental liver anatomy,WHO cyst classification
