Asakawa Ayaka, Horio Hirotoshi, Yamamichi Takashi, Okui Masayuki, Harada Masahiko
Department of Thoracic Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22, Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan.
Gen Thorac Cardiovasc Surg. 2020 Jan;68(1):38-42. doi: 10.1007/s11748-019-01149-9. Epub 2019 May 31.
The purpose of this study was to clarify the surgical outcome for HIV-infected patients with non-small-cell lung cancer (NSCLC).
Six HIV-positive patients underwent lung resection as treatment for NSCLC at our hospital from July 2010 to December 2017. Their clinical information was collected based upon review of their medical records.
All the patients included in this study had received highly active antiretroviral therapy (HAART) before lung resection with a mean duration of 99 months. Five patients underwent lobectomy and one patient underwent segmentectomy. Median preoperative CD4-positive T-cell count was 234/µL (range 138-428/µL). One patient contracted pneumonitis within 30 days post-surgery, whereas others had no postoperative complications. There was no postoperative mortality. For four patients, the pathological stage was upstaged compared to their clinical stage; IA1-IA3 (1 patient), IA3-IIB (1 patient), IB-IIIA (1 patient), and IB-IIIB (1 patient). Two patients died of lung cancer 2 years after surgery.
Surgical treatment for HIV-infected patients with NSCLC receiving HAART therapy and keeping adequate CD4-positive T-cell counts is safe and feasible. Preoperative precise staging using diagnostic imaging is difficult for these patients.
本研究旨在阐明感染人类免疫缺陷病毒（HIV）的非小细胞肺癌（NSCLC）患者的手术疗效。
2010年7月至2017年12月期间，6例HIV阳性患者在我院接受了肺切除术以治疗NSCLC。通过查阅病历收集他们的临床信息。
本研究纳入的所有患者在肺切除术前均接受了高效抗逆转录病毒治疗（HAART），平均疗程为99个月。5例行肺叶切除术，1例行肺段切除术。术前CD4阳性T细胞计数中位数为234/µL（范围138 - 428/µL）。1例患者在术后30天内发生肺炎，其他患者无术后并发症。无术后死亡病例。4例患者的病理分期较临床分期上调；IA1 - IA3期（1例）、IA3 - IIB期（1例）、IB - IIIA期（1例）和IB - IIIB期（1例）。2例患者术后2年死于肺癌。
对于接受HAART治疗且CD4阳性T细胞计数充足的HIV感染NSCLC患者，手术治疗是安全可行的。对这些患者进行术前诊断性影像学精确分期存在困难。
