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中国肺癌合并 HIV 感染患者的临床和计算机断层扫描表现:一项多中心研究。

Clinical and computed tomography findings in Chinese lung cancer patients with HIV infection: A multi-center study.

机构信息

Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.

Department of Radiology, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai, China.

出版信息

Thorac Cancer. 2017 May;8(3):238-245. doi: 10.1111/1759-7714.12429. Epub 2017 Mar 15.

Abstract

BACKGROUND

The study was conducted to investigate clinical and computed tomography (CT) features in Chinese lung cancer patients with human immunodeficiency virus (HIV).

METHODS

Forty consecutive lung cancer patients with HIV were included. Clinical data were collected, and CT features were reviewed and measured. The factors associated with stages of cancer and the CT features with opportunistic pulmonary infections (OPIs) were also analyzed.

RESULTS

Thirty-four of the patients were men (85%), and the mean age was 57.5 years. The mean CD4 count was 288 cells/μL, and 23 patients received highly active antiretroviral therapy. OPIs were common (50%). The major histological type (85%) was non-small cell lung cancer (NSCLC), and 15 NSCLC patients (44%) were in stages IIIb and IV. NSCLC patients with an OPI were more common in the advanced stages compared with those without an OPI (P = 0.04). There were no significant differences in advanced and non-advanced stages in terms of CD4 level, highly active antiretroviral therapy, and smoking (P = 0.31, P = 1.00; P = 0.49, respectively). The average size of tumors was 4.5 cm. Irregularly shaped or larger sized tumors were associated with OPIs (P = 0.03, P = 0.04, respectively).

CONCLUSIONS

The persistence of locally irregular and large lesions in middle-aged men with HIV and a history of OPIs should be an alert for lung cancer, and clinical management is needed.

摘要

背景

本研究旨在探讨中国肺癌合并人类免疫缺陷病毒(HIV)感染患者的临床和计算机断层扫描(CT)特征。

方法

纳入 40 例连续的肺癌合并 HIV 感染患者。收集临床资料,回顾并测量 CT 特征。分析与癌症分期相关的因素以及与机会性肺部感染(OPI)相关的 CT 特征。

结果

34 例患者为男性(85%),平均年龄为 57.5 岁。平均 CD4 计数为 288 个/μL,23 例患者接受了高效抗逆转录病毒治疗。OPI 很常见(50%)。主要组织学类型(85%)为非小细胞肺癌(NSCLC),15 例 NSCLC 患者(44%)处于 IIIb 和 IV 期。与无 OPI 的患者相比,有 OPI 的 NSCLC 患者更常见于晚期(P=0.04)。在 CD4 水平、高效抗逆转录病毒治疗和吸烟方面,晚期和非晚期阶段之间无显著差异(P=0.31、P=1.00;P=0.49,分别)。肿瘤的平均大小为 4.5cm。形状不规则或较大的肿瘤与 OPI 相关(P=0.03、P=0.04,分别)。

结论

对于有 OPI 病史的中年男性,HIV 感染者中持续存在局部不规则和大的病变应警惕肺癌,需要进行临床管理。

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