Clinical features of 14 cases with bladder cancer infected with human immunodeficiency virus

doi:10.3877/cma.j.issn.1674-1358.2023.05.010

Abstract

Abstract:

Objective

To investigate the preoperative and postoperative laboratory examination results, pathological types, treatment methods and prognosis of patients with human immunodeficiency virus (HIV) infection and bladder cancer, and to provide clinical reference for the prevention and treatment of HIV positive patients with bladder cancer.

Methods

Total of 14 patients with HIV infection complicated with bladder cancer and treated in Beijing Ditan Hospital, Capital Medical University and Beijing Beijing You’an Hospital, Capital Medical University from December 2013 to April 2021 were enrolled. The retrospective study parameters included HIV infection route, regular treatment, HIV viral load and number of CD4⁺ T lymphocytes prior to surgery, and preoperative laboratory examination; details specific to bladder cancer included pathological stage and grade, treatment, recurrence at 3 months and longer-term follow-up. The statistical analysis were carried out by descriptive statistical methods.

Results

Among the 14 patients, 13 cases (93%) were male and 1 case (7%) was female, with an average age of (48.93 ± 13.83) years old. There were 9 patients who received regular antiretroviral therapy after HIV infection, and the other 5 patients did not receive regular treatment. Preoperative laboratory tests: CD4⁺ T lymphocytes: 368 (254, 580) cells/μl, white blood cells: 6.17 (4.94, 7.02) × 10⁹/L, red blood cells: 4.16 (3.70, 4.68) × 10¹²/L, platelet: (199 ± 60.05) × 10⁹/L, creatinine: 70.85 (65.50, 75.25) μmol/L, albumin: 41.50 (39.60, 44.45) g/L. All the 14 patients received surgical treatment, including 11 patients with bladder tumor resection and 3 patients with bladder cancer radical surgery. Three cases were pathologically invasive bladder cancer (MIBC), and the other 11 cases were non-invasive bladder cancer (NMIBC). There were 5 cases with high-grade urothelial carcinoma and 9 cases with low-grade urothelial carcinoma. Three months after operation, there were 3 cases of recurrence, 7 cases of non-recurrence and 4 cases not reviewed. During the long-term follow-up for 42 (20.5, 65) months, 2 cases died, 2 cases were lost to follow-up, and the other 10 cases survived, but 1 case occured liver metastasis.

Conclusions

Patients with HIV-positive bladder cancer had lower age of onset than patients with HIV-negative bladder cancer, but there was no difference between different pathological grades and stages.

Key words: Human immunodeficiency virus, Bladder cancer, Treatment

Yu Zhang, Wenrui Xue, Xin Wang, Xuyu Li, Xudong Wang, Pengfei Yuan, Yurun Liang, Zhixing Han, Haijian Zhang, Qingjun Liu, Shiqi Ji. Clinical features of 14 cases with bladder cancer infected with human immunodeficiency virus[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2023, 17(05): 354-358.

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References 28

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临床资料	数值
男/女（例）	13/1
年龄[ ± s，岁]	48.93 ± 13.83
传播途径[例（%）]
同性	6（42.86）
异性	3（21.43）
不详	5（35.71）
经ART [例（%）]
是	9（64.29）
否	5（35.71）
术前HIV检测[例（%）]
未检测	4（28.57）
低于检测下限	7（50.00）
< 40拷贝/μl	1（7.14）
56拷贝/μl	1（7.14）
术前CD4⁺ T淋巴细胞计数[M（P25，P75），个/μl]	368（254，580）
术前CD4⁺ T淋巴细胞分布[例（%）]
> 200个/μl	12（85.72）
< 200个/μl	1（7.14）
未检测	1（7.14）

临床资料	数值
男/女（例）	13/1
年龄[ ± s，岁]	48.93 ± 13.83
传播途径[例（%）]
同性	6（42.86）
异性	3（21.43）
不详	5（35.71）
经ART [例（%）]
是	9（64.29）
否	5（35.71）
术前HIV检测[例（%）]
未检测	4（28.57）
低于检测下限	7（50.00）
< 40拷贝/μl	1（7.14）
56拷贝/μl	1（7.14）
术前CD4⁺ T淋巴细胞计数[M（P25，P75），个/μl]	368（254，580）
术前CD4⁺ T淋巴细胞分布[例（%）]
> 200个/μl	12（85.72）
< 200个/μl	1（7.14）
未检测	1（7.14）

实验室指标	数值
白细胞
计数[M（P25，P75），× 10⁹/L]	6.165（4.935，7.020）
低于参考值下限[例（%）]	3（21.43）
红细胞
计数[M（P25，P75），× 10⁹/L]	4.160（3.695，4.678）
低于参考值下限[例（%）]	6（42.86）
血小板
计数（ ± s，× 10⁹/L）	199.00 ± 60.05
低于参考值下限[例（%）]	1（7.14）
肌酐
水平[M（P25，P75），μmol/L]	70.85（65.5，75.25）
高于参考值上限[例（%）]	1（7.14）
白蛋白
水平[M（P25，P75），g/L]	41.5（39.6，44.45）
低于参考值下限[例（%）]	4（28.57）

实验室指标	数值
白细胞
计数[M（P25，P75），× 10⁹/L]	6.165（4.935，7.020）
低于参考值下限[例（%）]	3（21.43）
红细胞
计数[M（P25，P75），× 10⁹/L]	4.160（3.695，4.678）
低于参考值下限[例（%）]	6（42.86）
血小板
计数（ ± s，× 10⁹/L）	199.00 ± 60.05
低于参考值下限[例（%）]	1（7.14）
肌酐
水平[M（P25，P75），μmol/L]	70.85（65.5，75.25）
高于参考值上限[例（%）]	1（7.14）
白蛋白
水平[M（P25，P75），g/L]	41.5（39.6，44.45）
低于参考值下限[例（%）]	4（28.57）

指标	例（%）
TNM分期
NMIBC	11（78.57）
MIBC	3（21.43）
病理分级
级别	5（35.71）
低级别	9（64.29）
手术方式
膀胱肿瘤电切	11（78.57）
膀胱癌根治	3（21.43）
术后3个月复查
复发电切	3（21.43）
未复发	7（50.00）
未复查	4（28.57）
结局
存活	10（71.44）
进展为MIBC	1（7.14）
死亡	2（14.28）
失访	2（14.28）

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