Lyter D W, Bryant J, Thackeray R, Rinaldo C R, Kingsley L A
Department of Medicine, Graduate School of Public Health, University of Pittsburgh, PA, USA.
J Clin Oncol. 1995 Oct;13(10):2540-6. doi: 10.1200/JCO.1995.13.10.2540.
To determine if the rates of malignancies other than Kaposi's sarcoma (KS) and non-Hodgkin's lymphoma (NHL) are increased in human immunodeficiency virus (HIV)-infected homosexual men.
From 1984 through 1993, 1,199 homosexual men were studied in the Pittsburgh component of the Multicenter AIDS Cohort Study (MACS), an examination of the natural history of HIV infection. The cohort consisted of 769 HIV-seronegative (SN) participants and 430 seropositive (SP) members who were either seroprevalent at the time of enrollment or who seroconverted during the study. Cancer incidence data were collected through semiannual visits, phone interviews, medical records, and death certificates. Five thousand seven hundred eight person-years and 2,344 person-years were contributed to the study by the SN and SP men, respectively.
In addition to 44 cases of KS, 13 NHLs, and 3 CNS lymphomas (CNSLs), 27 other malignancies occurred (three nonmelanoma skin cancers and eight other malignancies in the SP group, eight nonmelanoma skin cancers, and eight other malignancies in the SN group). Age-adjusted rates were calculated for both groups and compared with each other and with rates for the general male population in Pennsylvania. There were no differences between the SN group and the general population. Among the SP group, the combined frequency of all cancers other than KS, NHL, CNSL, and nonmelanoma skin cancers was statistically significantly increased in comparison to both the SN group and the general population. This increase was secondary to an unusually increased frequency of both seminoma and Hodgkin's disease.
These findings support the hypothesis that the incidences of cancers other than KS and lymphoma are moderately increased in the setting of HIV infection and immunosuppression.
确定感染人类免疫缺陷病毒（HIV）的同性恋男性中，除卡波西肉瘤（KS）和非霍奇金淋巴瘤（NHL）之外的其他恶性肿瘤发病率是否升高。
1984年至1993年期间，在多中心艾滋病队列研究（MACS）的匹兹堡部分对1199名同性恋男性进行了研究，该研究旨在考察HIV感染的自然史。该队列由769名HIV血清阴性（SN）参与者和430名血清阳性（SP）成员组成，后者在入组时血清呈阳性或在研究期间发生血清转换。通过半年一次的访视、电话访谈、病历和死亡证明收集癌症发病数据。SN组和SP组分别为该研究贡献了5708人年和2344人年的数据。
除44例KS、13例NHL和3例中枢神经系统淋巴瘤（CNSL）外，还发生了27例其他恶性肿瘤（SP组有3例非黑色素瘤皮肤癌和8例其他恶性肿瘤，SN组有8例非黑色素瘤皮肤癌和8例其他恶性肿瘤）。计算了两组的年龄调整发病率，并相互比较以及与宾夕法尼亚州普通男性人群的发病率进行比较。SN组与普通人群之间无差异。在SP组中，与SN组和普通人群相比，KS、NHL、CNSL和非黑色素瘤皮肤癌以外的所有癌症的合并发病率在统计学上显著升高。这种升高是由于精原细胞瘤和霍奇金病的发病率异常增加所致。
这些发现支持以下假设，即在HIV感染和免疫抑制的情况下，KS和淋巴瘤以外的其他癌症发病率会适度升高。
