Nath Jyotiman, Neog Moniprom, Iqbal Asif, Sarma Anupam, Khanikar Duncan, M L Anjana
Department of Radiation Oncology, Dr. B. Borooah Cancer Institute, Guwahati, Assam 781016 India.
Department of Haemato Oncology, Dr. B. Borooah Cancer Institute, Guwahati, India.
Indian J Surg Oncol. 2024 Sep;15(3):457-462. doi: 10.1007/s13193-024-01927-9. Epub 2024 Mar 19.
The unique case study presented here explores an exceptionally rare occurrence in an HIV-positive female-synchronous diagnoses of anal squamous cell carcinoma and diffuse large B cell lymphoma (DLBCL) of the stomach. With limited existing literature on such clinical scenarios, this case serves as an unprecedented insight into the complexities of managing such synchronous malignancies in HIV-positive patients. The article also examines the heightened risk of specific cancer types in individuals living with HIV compared to those without the virus, focusing on AIDS-defining cancers such as Kaposi sarcoma, various lymphomas (including Burkitt lymphoma, immunoblastic lymphoma, and primary central nervous system lymphoma), and invasive cervical cancer. Additionally, it highlights an increased incidence and severity of other cancers amongst HIV-positive individuals, including Hodgkin lymphoma, anal cancer, testicular cancer, melanoma, various skin and superficial eye cancers, and leiomyosarcoma. The article discusses the challenges in the treatment plan, the impact of HIV status on the patient's condition, and the evolving landscape of cancer risk in people living with HIV. Despite significant progress in HIV care, cancer remains a paramount health concern for this population, necessitating tailored approaches and further research to ensure improved outcomes for individuals facing this dual challenge. The case highlights the need for greater inclusivity of PLWH in cancer clinical trials and reinforces the importance of equitable cancer care for this unique patient demographic.
本文所呈现的独特病例研究探讨了一名HIV阳性女性中极为罕见的情况——同时诊断出肛门鳞状细胞癌和胃弥漫性大B细胞淋巴瘤(DLBCL)。鉴于关于此类临床情况的现有文献有限,该病例为深入了解HIV阳性患者中此类同步恶性肿瘤的管理复杂性提供了前所未有的视角。文章还研究了与未感染病毒者相比,HIV感染者患特定癌症类型的风险增加情况,重点关注定义艾滋病的癌症,如卡波西肉瘤、各种淋巴瘤(包括伯基特淋巴瘤、免疫母细胞淋巴瘤和原发性中枢神经系统淋巴瘤)以及浸润性宫颈癌。此外,文章强调了HIV阳性个体中其他癌症的发病率和严重程度增加,包括霍奇金淋巴瘤、肛门癌、睾丸癌、黑色素瘤、各种皮肤和浅表眼癌以及平滑肌肉瘤。文章讨论了治疗方案中的挑战、HIV状态对患者病情的影响以及HIV感染者癌症风险的不断变化情况。尽管在HIV治疗方面取得了重大进展,但癌症仍然是这一人群极为关注的健康问题,需要采取针对性方法并进一步开展研究,以确保面临这一双重挑战的个体能有更好的治疗结果。该病例凸显了在癌症临床试验中更广泛纳入HIV感染者的必要性,并强化了为这一独特患者群体提供公平癌症护理的重要性。