人类免疫缺陷病毒相关的结肠腺癌:临床病理特征与预后

Human immunodeficiency virus-associated adenocarcinoma of the colon: clinicopathologic findings and outcome.

作者信息

Chapman Christopher, Aboulafia David M, Dezube Bruce J, Pantanowitz Liron

机构信息

Department of Pathology, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA, USA.

出版信息

Clin Colorectal Cancer. 2009 Oct;8(4):215-9. doi: 10.3816/CCC.2009.n.036.

Abstract

BACKGROUND

Patients infected with Human immunodeficiency virus (HIV) living longer with antiretroviral therapy (ART) are more likely to develop non-AIDS-defining cancers such as adenocarcinoma of the colon. There have been limited case reports regarding HIV-associated colon adenocarcinoma. The aim of this study was to characterize the clinicopathologic findings and outcome in a series of HIV-infected patients diagnosed and treated for colon adenocarcinoma.

PATIENTS AND METHODS

A retrospective study involving HIV-related colon adenocarcinoma was performed. Cases were accrued from the personal archives and published case reports. Data regarding demographics, HIV acquisition, ART use, immunosuppression, cancer location, pathology, and outcome were extracted and analyzed.

RESULTS

A total of 17 patients were identified, including 7 personal cases. Patients were of average age 43 years (range, 25-67 years) and predominantly male (male:female ratio, 14:3). Most carcinomas (57%) involved the right colon, were largely TNM stage 4 cancers (47%), and, when present, metastases were mainly to the liver. Many (47%) individuals died within 1-26 months after their cancer diagnosis. Immunosuppression (AIDS diagnosis and/or CD4+ < 500 cells/mm3) did not appear to correlate with tumor grade, stage, or an adverse outcome.

CONCLUSION

These data show that HIV-infected patients with adenocarcinoma of the colon tend to be young men with a high incidence of right-sided involvement. Additional research is needed to determine if screening HIV-infected individuals for colon cancer should include younger patients and involve the entire colon.

摘要

背景

接受抗逆转录病毒疗法(ART)的人类免疫缺陷病毒(HIV)感染者寿命延长,更易患非艾滋病定义性癌症,如结肠腺癌。关于HIV相关结肠腺癌的病例报告有限。本研究的目的是描述一系列经诊断和治疗的HIV感染结肠腺癌患者的临床病理特征及预后。

患者与方法

开展一项关于HIV相关结肠腺癌的回顾性研究。病例来自个人档案和已发表的病例报告。提取并分析有关人口统计学、HIV感染途径、ART使用情况、免疫抑制、癌症部位、病理及预后的数据。

结果

共确定17例患者,包括7例个人病例。患者平均年龄43岁(范围25 - 67岁),男性居多(男女比例为14:3)。大多数癌(57%)累及右半结肠,大多为TNM 4期癌症(47%),如有转移,主要转移至肝脏。许多(47%)患者在癌症诊断后1 - 26个月内死亡。免疫抑制(艾滋病诊断和/或CD4 +细胞计数< 500个/立方毫米)似乎与肿瘤分级、分期或不良预后无关。

结论

这些数据表明,HIV感染的结肠腺癌患者往往是年轻男性,右侧受累发生率高。需要进一步研究以确定对HIV感染者进行结肠癌筛查是否应包括更年轻的患者并涵盖整个结肠。

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