Singh B, Balwally A N, Shaha A R, Rosenfeld R M, Har-El G, Lucente F E
Department of Otolaryngology, State University of New York Health Science Center at Brooklyn, NY, USA.
Arch Otolaryngol Head Neck Surg. 1996 Jun;122(6):639-43. doi: 10.1001/archotol.1996.01890180047012.
To evaluate the incidence, distribution, and course of squamous cell carcinoma (SCC) of the upper aerodigestive tract in patients infected with the human immunodeficiency virus (HIV) and compare it to SCC in non-HIV-infected patients.
Case-control study of all patients with SCC during a 9.5-year period from January 1985 through June 1994.
Two academic tertiary care centers in a metropolitan location.
Five hundred thirty-nine patients (18 to 95 years old) with SCC of the upper aerodigestive tract.
Infection with HIV was present in 4.5% of the patients with SCC of the upper aerodigestive tract. Patients infected with HIV were significantly younger than noninfected patients (P < or = < .001), accounting for 21.3% of those patients younger than 45 years (P < .001). No significant difference in tumor location was present between HIV-infected and noninfected patients; however, HIV-infected patients had larger tumors (P = .004) and a more advanced tumor stage (TNM classification) at presentation (P = .05). Tumor-related survival was significantly poorer in patients with HIV infection (P = .01), with 57% at 1 year and 32% at 2 years, compared with 74% and 59%, for non-HIV-infected patients. The detrimental effect of HIV infection on survival remained significant after adjusting for the confounding effects of age, tumor stage, and location of the tumor. All study patients with HIV infection had cancer risk factors such as tobacco and/or alcohol abuse.
Infection with HIV possibly accelerates the development of SCC in patients with significant risk factors, presumably by impairing normal immune surveillance mechanisms. The decreased survival rates among these patients suggests that the SCC may be more aggressive or that other cofactors assume greater importance. A history of tobacco and/or alcohol abuse in patients with HIV infection warrants aggressive screening and early detection, to allow for early detection, which may help increase survival.
评估感染人类免疫缺陷病毒（HIV）的患者上消化道鳞状细胞癌（SCC）的发病率、分布及病程，并与未感染HIV的患者的SCC进行比较。
对1985年1月至1994年6月这9.5年期间所有SCC患者进行病例对照研究。
大都市地区的两家学术性三级医疗中心。
539例（年龄在18至95岁之间）上消化道SCC患者。
上消化道SCC患者中4.5%感染了HIV。感染HIV的患者明显比未感染患者年轻（P≤0.001），占45岁以下患者的21.3%（P<0.001）。HIV感染患者与未感染患者在肿瘤部位上无显著差异；然而，HIV感染患者的肿瘤更大（P = 0.004），且就诊时肿瘤分期（TNM分类）更晚（P = 0.05）。HIV感染患者的肿瘤相关生存率明显较差（P = 0.01），1年时为57%，2年时为32%，而未感染HIV的患者分别为74%和59%。在调整了年龄、肿瘤分期和肿瘤部位的混杂效应后，HIV感染对生存的不利影响仍然显著。所有感染HIV的研究患者都有烟草和/或酒精滥用等癌症危险因素。
HIV感染可能会加速有显著危险因素患者的SCC发展，推测是通过损害正常的免疫监视机制。这些患者生存率降低表明SCC可能更具侵袭性，或者其他辅助因素更为重要。HIV感染患者有烟草和/或酒精滥用史，需要积极筛查和早期检测，以便早期发现，这可能有助于提高生存率。
