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. 2020:27:41.
doi: 10.1051/parasite/2020024. Epub 2020 Jun 3.

International consensus on terminology to be used in the field of echinococcoses

Dominique A Vuitton  1 , Donald P McManus  2 , Michael T Rogan  3 , Thomas Romig  4 , Bruno Gottstein  5 , Ariel Naidich  6 , Tuerhongjiang Tuxun  7 , Hao Wen  7 , Antonio Menezes da Silva  8 ; World Association of Echinococcosis
Collaborators, Affiliations

International consensus on terminology to be used in the field of echinococcoses

Dominique A Vuitton et al. Parasite. 2020.

Abstract
in English, French

Echinococcoses require the involvement of specialists from nearly all disciplines; standardization of the terminology used in the field is thus crucial. To harmonize echinococcosis terminology on sound scientific and linguistic grounds, the World Association of Echinococcosis launched a Formal Consensus process. Under the coordination of a Steering and Writing Group (SWG), a Consultation and Rating Group (CRG) had the main missions of (1) providing input on the list of terms drafted by the SWG, taking into account the available literature and the participants' experience; and (2) providing independent rating on all debated terms submitted to vote. The mission of the Reading and Review Group (RRG) was to give an opinion about the recommendation paper in terms of readability, acceptability and applicability. The main achievements of this process were: (1) an update of the current nomenclature of Echinococcus spp.; (2) an agreement on three names of diseases due to Echinococcus spp.: Cystic Echinococcosis (CE), Alveolar Echinococcosis (AE) and Neotropical Echinococcosis (NE), and the exclusion of all other names; (3) an agreement on the restricted use of the adjective "hydatid" to refer to the cyst and fluid due to E. granulosus sensu lato; and (4) an agreement on a standardized description of the surgical operations for CE, according to the "Approach, cyst Opening, Resection, and Completeness" (AORC) framework. In addition, 95 "approved" and 60 "rejected" terms were listed. The recommendations provided in this paper will be applicable to scientific publications in English and communication with professionals. They will be used for translation into other languages spoken in endemic countries.

Title: Consensus international sur la terminologie à utiliser dans le domaine des échinococcoses.

Abstract: Les échinococcoses impliquent l’intervention de spécialistes de presque toutes les disciplines et une standardisation de la terminologie utilisée dans le domaine est donc cruciale. Pour harmoniser la terminologie des échinococcoses sur des bases scientifiques et linguistiques bien étayées, l’Association Mondiale de l’Échinococcose a entrepris un processus de « Consensus Formalisé ». Sous la coordination d’un Groupe de Pilotage et de Rédaction (GPR), un Groupe de Consultation et de Classement (GCC) a reçu les missions suivantes : (1) fournir un avis sur une liste de termes établie par le GPR, en prenant en compte les références scientifiques disponibles et l’expérience des participants ; (2) fournir un classement indépendant sur tous les termes débattus et soumis au vote. La mission du Groupe de Lecture et de Revue critique (GLR) était de donner un avis formel sur l’article de recommandations en termes de facilité de lecture, d’acceptabilité et d’applicabilité. Les principales avancées obtenues au terme de ce processus sont les suivantes: (1) une actualisation de la nomenclature actuelle des espèces d’Echinococcus ; (2) un accord sur les noms des trois principales maladies humaines dues aux espèces d’Echinococcus : l’échinococcose kystique (EK), l’échinococcose alvéolaire (EA) et l’échinococcose néotropicale (EN), à l’exclusion de toute autre dénomination ; (3) la restriction de l’usage de l’adjectif « hydatique » au kyste et au liquide/fluide produit par E. granulosus sensu lato ; et (4) une description standardisée des interventions chirurgicales pour l’EK, selon le système AORC (pour « Approche », « Ouverture », « Résection » et « Complétude »). De plus, 95 termes « approuvés » et 60 termes « rejetés » ont été listés. Les recommandations données dans cet article seront applicables aux publications scientifiques en anglais et à la communication avec les professionnels. Elles seront utilisées pour la traduction dans les autres langues parlées dans les zones d’endémie.

Keywords: Alveolar Echinococcosis; Cystic Echinococcosis; Formalized consensus; Neotropical Echinococcosis: Echinococcus spp.; Terminology.

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Figures

Figure 1
Figure 1
Time schedule and main activities within the “Formal consensus” process for the definition of the terminology of echinococcosis.
Figure 2A and B
Figure 2A and B
General description of the egg and oncosphere of Echinococcus spp, according to Jabbar et al., 2010 [27]. (A) Schematic diagram of an oncosphere illustrating the structure and bilateral symmetry in the pattern of hooks and cellular organization of the hexacanth embryo. VL: vitelline layer; EM: embryophore; GL: granular layer; OM: oncospheral membrane; Hex: hexacanth embryo. (B) Cellular organization of the oncosphere. Oncospheres are approximately 25 × 30 μm.
Figure 2C
Figure 2C
General description of the metacestode of Echinococcus spp. (see also Table 1B and Fig. 3).
Figure 3
Figure 3
“AORC” nomenclature framework for CE surgery. (A) (top) – Vocabulary and acronyms. AORC: acronym for Approach, Opening, Resection and Completeness; CE: cystic echinococcosis; OC: opened cyst; NOC: non-opened cyst. (B) (bottom) – A. Schematic structure of CE cyst: the CE cyst consists (from inside to outside) of the germinal layer, laminated layer and adventitial layer. B. Total cystectomy requires the resection of all three layers completely. C. Subtotal cystectomy requires the nearly total resection of all three layers; only parts of the adventitial layer are preserved because of surgical safety. D. Partial cystectomy refers to the incomplete resection of any of three layers (usually of the adventitial layer) due to technical and safety issue. E. Hepatectomy requires the en bloc resection of part of liver parenchyma, following the rules of hepatic resection.
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