Operative safety of HIV-infected patients with colorectal cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 YANG Jing ¹ , CHEN Tingyu ¹ , ZHAO Yong ¹ , WEI Jia ² , HE Yong ¹ , HUA Xin ¹ , FENG Shifeng ¹ , WANG Hua ¹

1. Department of General Surgery and Oncology, Public Health Clinical Center of Chengdu, Chengdu 610061, P. R. China;
2. Chengdu Experimental Foreign Languages School, Chengdu 611731, P. R. China;

Corresponding?author：

YANG Jing, Email: yangjingssss@163.com

Keywords：

human immunodeficiency virus; colorectal cancer; CD₄ T cell; cellular immunity; postoperative complication

DOI：

10.7507/1007-9424.201803042

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore the operative safety of HIV-infected patients with colorectal cancer in different degrees of immunodeficiency. Methods A total of 56 patients, including 26 cases of HIV positive (HIV-positive group) and 28 cases of HIV negative (HIV-negative group), who underwent radical operation for colorectal cancer between January 2012 and December 2015, were enrolled in our study. We divided HIV-positive patients into three groups according to CD₄⁺ T cells count in peripheral venous blood before 1 day (D₀) of the surgery (HIV-positive Ⅰgroup with CD₄⁺ T cells count >500/μL, HIV-positive Ⅱgroup with CD ₄⁺ T cells count among 200–500/μL, and HIV-positive Ⅲ group with CD₄⁺ T cells count <200/μL). Non-infective patients were enrolled in HIV-negative group. Leukocyte count, neutrophil percentage, lymphocyte percentage, CD ₄⁺ T cells subsets count, and CD₈⁺ T cells subsets count of the 4 groups in different time points were tested. In addition, we compared postoperative complications, carcinoembryonic antigen (CEA), and postoperative survival rate between the HIV-positive group and the HIV-negative group. Results In 56 cases, there were 26 cases of HIV-positive patients (including 10 cases of HIV-positive Ⅰ group, 8 cases of HIV-positive Ⅱ group and 10 cases of HIV-positive Ⅲ group). Variance results about repeated measurement data showed that, variation of leukocyte count, neutrophil percentage, lymphocyte percentage, and CD₈⁺ T cells count among 4 groups after surgery had no statistical significance (P>0.05), in addition there was no significant on time effect and interactive effect of time and group (P>0.05). CD₄⁺ T cells count in the 4 groups showed a trend from decline to rising with time going, and the time effect had statistical significance (P<0.05). The speed and amplitude of decline and recovery of CD₄⁺ T cells count were different among groups, and the group effect had statistical significance (P<0.05). CEA showed a trend of decline after surgery in both HIV-positive group and HIV-negative group, and the time effect had statistical significance (P<0.05), but the group effect and interactive effect of time and group had no statistical significance (P>0.05). No statistically significant differences in amount of blood loss, duration of surgery, postoperative stay, nor complication rate (including incision infection, pulmonary infection, and opportunistic infections after surgery) were found between the HIV-positive group and the HIV-negative group (P>0.05). The overall survival situation of the HIV-positive group and the HIV-negative group had no statistical significance (P>0.05). Conclusions Radical operation for HIV-infected patients with colorectal cancer has an impact of " first inhibition and recovery” on cellular immunity over a period of time. Incidence of postoperative complications and survival rates are similar in HIV-positive patients and HIV-negative patients. In a word, it’s safe to have radical operation for colorectal cancer in HIV-positive patients under the proper perioperative treatment.

Citation： YANG Jing, CHEN Tingyu, ZHAO Yong, WEI Jia, HE Yong, HUA Xin, FENG Shifeng, WANG Hua. Operative safety of HIV-infected patients with colorectal cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2018, 25(8): 934-940. doi: 10.7507/1007-9424.201803042 Copy

1.	Leal FE, Premeaux TA, Abdel-Mohsen M, et al. Role of natural killer cells in HIV-associated malignancies. Front Immunol, 2017, 8: 315.
2.	Bonnet F, Lewden C, May T, et al. Malignancy-related causes of death in human immunodeficiency virus-infected patients in the era of highly active antiretroviral therapy. Cancer, 2004, 101(2): 317-324.
3.	Spittle MF. Spectrum of AIDS-associated malignant disorders. Lancet, 1998, 352(9131): 907.
4.	Geocze L, Mucci S, De Marco MA, et al. Quality of life and adherence to HAART in HIV-infected patients. Rev Saude Publica, 2010, 44(4): 743-749.
5.	Weber R, Ruppik M, Rickenbach M, et al. Decreasing mortality and changing patterns of causes of death in the Swiss HIV Cohort Study. HIV Med, 2013, 14(4): 195-207.
6.	Hasse B, Ledergerber B, Furrer H, et al. Morbidity and aging in HIV-infected persons: the Swiss HIV cohort study. Clin Infect Dis, 2011, 53(11): 1130-1139.
7.	Burkholder GA, Tamhane AR, Appell LE, et al. Short communication: viral suppression is associated with increased likelihood of colorectal cancer screening among persons living with HIV/AIDS. AIDS Res Hum Retroviruses, 2015, 31(5): 519-524.
8.	Deneve JL, Shantha JG, Page AJ, et al. CD4 count is predictive of outcome in HIV-positive patients undergoing abdominal operations. Am J Surg, 2010, 200(6): 694-699.
9.	Chiu CG, Smith D, Salters KA, et al. Overview of cancer incidence and mortality among people living with HIV/AIDS in British Columbia, Canada: implications for HAART use and NADM development. BMC Cancer, 2017, 17(1): 270.
10.	Robbins HA, Pfeiffer RM, Shiels MS, et al. Excess cancers among HIV-infected people in the United States. J Natl Cancer Inst, 2015, 107(4): dju503.
11.	Collaboration of Observational HIV Epidemiological Research Europe (COHERE) in EuroCoord; Lewden C, Bouteloup V, et al. All-cause mortality in treated HIV-infected adults with CD4 ≥500/mm³ compared with the general population: evidence from a large European observational cohort collaboration. Int J Epidemiol, 2012, 41(2): 433-445.
12.	Towner WJ, Xu L, Leyden WA, et al. The effect of HIV infection, immunodeficiency, and antiretroviral therapy on the risk of hepatic dysfunction. J Acquir Immune Defic Syndr, 2012, 60(3): 321-327.
13.	Achhra AC, Petoumenos K, Law MG. Relationship between CD4 cell count and serious long-term complications among HIV-positive individuals. Curr Opin HIV AIDS, 2014, 9(1): 63-71.
14.	中華醫學會. 臨床診療指南-外科學分冊. 北京: 人民衛生出版社, 2006: 292-335.
15.	中華醫學會感染病學分會艾滋病學組. 艾滋病診療指南. 中華傳染病雜志, 2006, 24(2): 133-144.
16.	Nabatanzi R, Cose S, Joloba M, et al. Effects of HIV infection and ART on phenotype and function of circulating monocytes, natural killer, and innate lymphoid cells. AIDS Res Ther, 2018, 15(1): 7.
17.	Ni Choileain N, MacConmara M, Zang Y, et al. Enhanced regulatory T cell activity is an element of the host response to injury. J Immunol, 2006, 176(1): 225-236.
18.	劉保池. 艾滋病病毒感染者的圍手術期處理. 中華胃腸外科雜志, 2011, 14(7): 494-495.
19.	盧焱, 沈芳. HIV感染者行腹腔鏡手術后主要淋巴細胞亞群的變化. 中國艾滋病性病, 2007, 13(3): 207-209.
20.	寸新華, 鄭剛, 成永達, 等. HIV感染者行膽囊切除手術后主要淋巴細胞亞群的變化. 昆明醫學院學報, 2012, 33(8): 122-124.
21.	鄧建寧. HIV感染者行腹腔鏡手術對主要淋巴細胞亞群的影響觀察. 中國醫藥導刊, 2014, 16(3): 527-528.
22.	胡明輝, 魏國, 趙勇, 等. 腹腔鏡膽囊切除術對 HIV 感染者細胞免疫的影響. 世界華人消化雜志, 2014, 22(5): 700-704.
23.	楊滌, 趙紅心, 郜桂菊, 等. HIV/AIDS 手術切口愈合與 CD4⁺ T 淋巴細胞計數的關系. 中華流行病學雜志, 2014, 35(12): 1333-1336.
24.	Oh HK, Moon SH, Ryoo S, et al. Results of surgical treatment on benign anal diseases in Korean HIV-positive patients. J Korean Med Sci, 2014, 29(9): 1260-1265.
25.	Alfa-Wali M, Tait D, Allen-Mersh T, et al. Colorectal cancer in HIV positive individuals: the immunological effects of treatment. Eur J Cancer, 2011, 47(16): 2403-2407.

1. Leal FE, Premeaux TA, Abdel-Mohsen M, et al. Role of natural killer cells in HIV-associated malignancies. Front Immunol, 2017, 8: 315.
2. Bonnet F, Lewden C, May T, et al. Malignancy-related causes of death in human immunodeficiency virus-infected patients in the era of highly active antiretroviral therapy. Cancer, 2004, 101(2): 317-324.
3. Spittle MF. Spectrum of AIDS-associated malignant disorders. Lancet, 1998, 352(9131): 907.
4. Geocze L, Mucci S, De Marco MA, et al. Quality of life and adherence to HAART in HIV-infected patients. Rev Saude Publica, 2010, 44(4): 743-749.
5. Weber R, Ruppik M, Rickenbach M, et al. Decreasing mortality and changing patterns of causes of death in the Swiss HIV Cohort Study. HIV Med, 2013, 14(4): 195-207.
6. Hasse B, Ledergerber B, Furrer H, et al. Morbidity and aging in HIV-infected persons: the Swiss HIV cohort study. Clin Infect Dis, 2011, 53(11): 1130-1139.
7. Burkholder GA, Tamhane AR, Appell LE, et al. Short communication: viral suppression is associated with increased likelihood of colorectal cancer screening among persons living with HIV/AIDS. AIDS Res Hum Retroviruses, 2015, 31(5): 519-524.
8. Deneve JL, Shantha JG, Page AJ, et al. CD4 count is predictive of outcome in HIV-positive patients undergoing abdominal operations. Am J Surg, 2010, 200(6): 694-699.
9. Chiu CG, Smith D, Salters KA, et al. Overview of cancer incidence and mortality among people living with HIV/AIDS in British Columbia, Canada: implications for HAART use and NADM development. BMC Cancer, 2017, 17(1): 270.
10. Robbins HA, Pfeiffer RM, Shiels MS, et al. Excess cancers among HIV-infected people in the United States. J Natl Cancer Inst, 2015, 107(4): dju503.
11. Collaboration of Observational HIV Epidemiological Research Europe (COHERE) in EuroCoord; Lewden C, Bouteloup V, et al. All-cause mortality in treated HIV-infected adults with CD4 ≥500/mm³ compared with the general population: evidence from a large European observational cohort collaboration. Int J Epidemiol, 2012, 41(2): 433-445.
12. Towner WJ, Xu L, Leyden WA, et al. The effect of HIV infection, immunodeficiency, and antiretroviral therapy on the risk of hepatic dysfunction. J Acquir Immune Defic Syndr, 2012, 60(3): 321-327.
13. Achhra AC, Petoumenos K, Law MG. Relationship between CD4 cell count and serious long-term complications among HIV-positive individuals. Curr Opin HIV AIDS, 2014, 9(1): 63-71.
14. 中華醫學會. 臨床診療指南-外科學分冊. 北京: 人民衛生出版社, 2006: 292-335.
15. 中華醫學會感染病學分會艾滋病學組. 艾滋病診療指南. 中華傳染病雜志, 2006, 24(2): 133-144.
16. Nabatanzi R, Cose S, Joloba M, et al. Effects of HIV infection and ART on phenotype and function of circulating monocytes, natural killer, and innate lymphoid cells. AIDS Res Ther, 2018, 15(1): 7.
17. Ni Choileain N, MacConmara M, Zang Y, et al. Enhanced regulatory T cell activity is an element of the host response to injury. J Immunol, 2006, 176(1): 225-236.
18. 劉保池. 艾滋病病毒感染者的圍手術期處理. 中華胃腸外科雜志, 2011, 14(7): 494-495.
19. 盧焱, 沈芳. HIV感染者行腹腔鏡手術后主要淋巴細胞亞群的變化. 中國艾滋病性病, 2007, 13(3): 207-209.
20. 寸新華, 鄭剛, 成永達, 等. HIV感染者行膽囊切除手術后主要淋巴細胞亞群的變化. 昆明醫學院學報, 2012, 33(8): 122-124.
21. 鄧建寧. HIV感染者行腹腔鏡手術對主要淋巴細胞亞群的影響觀察. 中國醫藥導刊, 2014, 16(3): 527-528.
22. 胡明輝, 魏國, 趙勇, 等. 腹腔鏡膽囊切除術對 HIV 感染者細胞免疫的影響. 世界華人消化雜志, 2014, 22(5): 700-704.
23. 楊滌, 趙紅心, 郜桂菊, 等. HIV/AIDS 手術切口愈合與 CD4⁺ T 淋巴細胞計數的關系. 中華流行病學雜志, 2014, 35(12): 1333-1336.
24. Oh HK, Moon SH, Ryoo S, et al. Results of surgical treatment on benign anal diseases in Korean HIV-positive patients. J Korean Med Sci, 2014, 29(9): 1260-1265.
25. Alfa-Wali M, Tait D, Allen-Mersh T, et al. Colorectal cancer in HIV positive individuals: the immunological effects of treatment. Eur J Cancer, 2011, 47(16): 2403-2407.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Operative safety of HIV-infected patients with colorectal cancer

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content