Journal Article

Changes in the immune index before and after surgery in urinary malignancy patients with AIDS

Xue, Wenrui, Zhang, Yu, Zhang, Mengmeng, Huang, Zhen

2025

Overview

The immune index is an important marker of HIV immune function. Long-term clinical experience revealed that in urinary malignancy patients with AIDS who underwent radical surgery for malignant tumors, the preoperative and postoperative immune indices changed to different degrees, which affected patient prognosis. A total of 48 AIDS patients who underwent radical resection of malignant tumors in the Department of Urology of Beijing You ‘an Hospital between 2015 and 2023 were included, including 25 patients with kidney cancer, 12 patients with bladder cancer and 11 patients with prostate cancer. A paired t test was used to study the changes in the immune indices CD4 + T, CD8 + T, CD3 + T and CD4+/CD8 + T cells before and after surgery for different malignant tumors in the urinary tract. The chi-square test was used to study the effects of clinical variables such as age, sex, hypertension status, diabetes status, duration of operation, duration of HIV infection, duration of medication and viral load on preoperative and postoperative immune indices. The area under the ROC curve of the four immune indicators before and after surgery was compared to evaluate the influence of immune indicators on patient prognosis. Survival curves were drawn to study the prognostic risk of immune indicators. The mean CD4 + T, CD8 + T and CD3 + T-cell counts decreased before and after surgery in patients with renal, bladder and prostate cancer, and P < 0.05 according to paired t tests indicated statistical significance, while the CD4+/CD8 + T-cell ratio was not significantly different according to paired t tests. Clinical variables such as age, sex, hypertension status, diabetes status, duration of operation, duration of HIV infection, duration of medication and viral load had no statistically significant effects on the preoperative or postoperative immune indices. The area under the ROC curve of the four immune indices was compared, and the results showed that CD8 + T cells [preoperative AUC of 0.678 (P < 0.05) and postoperative AUC of 0.702 (P < 0.05)] were superior to the other indices. Survival curve analysis revealed that a decrease in CD4 + T, CD8 + T and CD3 + T cells after surgery led to a decrease in the survival rate of patients, but the results were not statistically significant. CD4 + T, CD8 + T and CD3 + T cells decreased before and after surgery in patients with malignant tumors of the urinary system complicated with AIDS, and CD8 + T cells had a statistically significant effect on patient prognosis compared with other immune indices.

• Publisher: Nature Publishing Group UK,Nature Publishing Group,Nature Portfolio
• Subject: 631/250 / 631/67 / 692/4025 / Acquired immune deficiency syndrome / Acquired Immunodeficiency Syndrome - complications / Acquired Immunodeficiency Syndrome - immunology / Adult / Aged / AIDS / AIDS patient / Cancer / CD3 antigen / CD4 antigen / CD4-Positive T-Lymphocytes - immunology / CD8 antigen / CD8-Positive T-Lymphocytes - immunology / Diabetes / Diabetes mellitus / Female / HIV / Human immunodeficiency virus / Humanities and Social Sciences / Humans / Hypertension / Immune index / Immune response / Lymphocytes / Lymphocytes T / Male / Malignancy / Malignant tumor of the urinary system / Medical prognosis / Middle Aged / multidisciplinary / Patients / Postoperative Period / Prognosis / Prostate cancer / Prostatic Neoplasms - immunology / Prostatic Neoplasms - surgery / ROC Curve / Science / Science (multidisciplinary) / Sexually transmitted diseases / Statistical analysis / STD / Surgery / Survival prognosis / Tumors / Urinary tract / Urologic Neoplasms - complications / Urologic Neoplasms - immunology / Urologic Neoplasms - mortality / Urologic Neoplasms - surgery / Viral Load