Oncological Features and Prognosis of HIV-positive Colorectal Cancer: An analysis using propensity score matching

Oncological Features and Prognosis of HIV-positive Colorectal Cancer: An analysis using propensity score matching | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Oncological Features and Prognosis of HIV-positive Colorectal Cancer: An analysis using propensity score matching Fuyu Yang, Defei Chen, Saed Woraikat, Chenglin Tang, Fan He, Yao Li, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-2556602/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background The purpose of this study was to compare the differences in oncological features, surgical safety and prognosis between HIV positive CRC patients and HIV negative CRC patients with the same T stage and the same tumor site. Patients and Methods We collected a total of 24 patients with HIV infection combined with CRC who underwent radical resection of CRC. With the method of random stratified sampling, A total of 363 postoperative patients with colorectal adenocarcinoma without HIV infection were collected. After propensity score matching(PSM), we got 72 patients (HIV + ∶HIV - =24∶48). The differences of perioperative serological indexes, surgical safety, oncological features and long-term prognosis were compared. Results Of 363 HIV negative CRC patients, 48 HIV negative patients were matched with 24 HIV positive patients. Compared with HIV negative patients, less HIV positive patients received chemotherapy, HIV + patients had fewer preoperative leukocytes, fewer postoperative leukocytes, fewer preoperative lymphocytes, lower CEA, more intraoperative bleeding, more metastatic lymph nodes, higher N stage, higher TNM stage, shorter overall survival and shorter progression free survival. Conclusion Compared with HIV negative CRC patients, HIV positive patients with the same T stage and the same tumor site have more metastatic lymph nodes and worse long-term survival after surgery, but the risk of surgery will not increase. colorectal cancer HIV propensity score matching oncological features surgical safety prognosis Figures Figure 1 Figure 2 Introduction Since 1996, since Acquired Immune Deficiency Syndrome (AIDS) patients generally accepted highly active antiretroviral therapy (HAART), the survival period of patients has significantly prolonged, and the incidence rate of AIDS defined cancers, Kaposi's sarcoma, non-Hodgkin lymphoma and cervical cancer has significantly decreased[ 1 – 5 ]. However, the incidence rate of non-AIDS-defining cancers (NADCs), such as CRC, liver cancer, lung cancer, anal cancer, and Hodgkin's disease has increased[ 6 , 7 ], which is related to the prolongation of life expectancy of AIDS patients. These NADCs account for an increasing proportion of deaths of HIV carriers. According to GLOBOCAN 2020[ 8 ] data, there was about 1.93 million new cases of CRC in the world in 2020, ranking third in malignant tumors (10.0%), only after breast cancer (11.7%) and lung cancer (11.4%); About 930000 (9.4%) people died, only after lung cancer (18.0%), ranking second in malignant tumors. The number of new cases and deaths of CRC in the world are increasing year by year. Compared with the general population, AIDS patients not only have an increased incidence rate of CRC, the age of invasion is earlier, but also their performance will be more advanced[ 9 ]. During the operation, our team found that there seemed to be more suspicious positive lymph nodes in CRC patients with HIV infection. However, under the same T stage and the same tumor site, the differences in oncological features and prognosis between HIV positive CRC patients and HIV negative patients were rarely reported. With the prolongation of life expectancy of HIV infected people and the increased risk of CRC among HIV infected people, it is very important to understand the prognosis and pathological features of CRC in HIV positive patients. Therefore, this study intends to compare the differences in oncological features, surgical safety and prognosis between HIV positive CRC patients and HIV negative CRC patients at the same T stage and the same tumor site. Materials And Methods Patients and methods We searched the clinical data of patients who were diagnosed as CRC complicated with HIV infection and underwent radical CRC resection from January 1, 2012 to March 31, 2022. A total of 24 cases were retrieved. After analysis, we found that the pathological classification of all HIV positive CRC patients was adenocarcinoma, and no preoperative neoadjuvant chemotherapy or radiotherapy was performed. Because our hospital has more than 1000 CRC radical operations every year, if we collect the clinical data of all patients, the workload is huge, so we use the method of random stratified sampling, we collect 363 patients who haven’t received preoperative neoadjuvant chemotherapy and radiotherapy, HIV negative colorectal adenocarcinoma and have undergone radical CRC resection. Data collection and definition We collected baseline data, perioperative indicators, oncological features and long-term postoperative data of patients. The baseline data include: 1. Basic information of patients: age, sex, tumor site (according to the International Classification of Diseases for Oncology, the tumor site of CRC is divided into proximal colon (ICD-O3C180-84), distal colon (ICD-O3C185-87) and rectum (ICD-O3C199, C209)), degree of differentiation, T stage, CRC family history, main complications (hypertension, diabetes, CHD(coronary atherosclerotic heart disease), COPD(chronic obstructive pulmonary disease)), smoking, drinking, abdominal surgery history, BMI(body mass index), chemotherapy and adverse reaction of chemotherapy. 2. Perioperative indicators: preoperative and postoperative leukocyte, hemoglobin, lymphocyte, albumin, preoperative CEA, CA19-9, intraoperative blood loss, operation time, time to first flatus, time to first defecation, time to first liquid intake, time to ambulation, postoperative hospital stay, postoperative complications (including postoperative bleeding, anastomotic leakage, wound infection, pulmonary infection, abdominal cavity infection,, urinary infection, retention of urine, lower limb deep vein thrombosis), admission to ICU, time to stopping antibiotics, hospitalization expenses, PS of one month after operation, decrease in hemoglobin, decrease in albumin, intraoperative blood transfusion, enterostomy, readmission within one month, death within one month, ASA score. 3. Oncological features: No. of metastatic lymph nodes, N stage, harvested lymph nodes, size of the largest lymph node(the longest diameter of the largest lymph node), metastasis, TNM stage, tumor size, margin, MSI, RAS gene mutation, BRAF gene mutation, MLH1, MSH2 MSH6 Ki-67. 4. Postoperative long-term data: progression free survival period, cause of death, postoperative long-term gastrointestinal discomfort (diarrhea, Dyssynergic defecation, abdominalgia, abdominal distension), and recurrent fever before or after surgery. Statistical analysis Propensity score matching (PSM) analysis is widely used because of its ability to minimize intervention or patient selection bias in non-randomized controlled or observational studies[ 10 ]. To reduce the impact of differences in baseline data between HIV positive and HIV negative patients on the results, especially the effect on the number of metastatic lymph nodes., we used PSM to pair HIV-positive and HIV-negative patients. We included a cohort of patients with nearly 15 times as many HIV-negative patients as HIV-positive patients before matching, and matching at 1:1 would have resulted in substantial data loss and reduced statistical power. Therefore, we matched at 1:2. Variables that may affect the number of peri-intestinal lymph node metastases and baseline data were used to construct propensity scores: age, sex, tumor site, degree of tumor differentiation, and T stage. The Matching package was used to match the data for propensity scores, and 1:2 matching was adopted, with the caliper width limit to 0.1*standard deviation of the logarithmic score, and the matched groups were considered balanced if the standardized mean difference (SMD) of the difference between them after matching was less than 0.1[ 11 ]. Categorical variables were expressed as frequency (%) and continuous variables were expressed as median (P25, P75). Categorical variables were analysed by Fisher’s exact or chi-square test and continuous variables by Mann-Whitney U test. P value less than 0.05 was considered statistically significant. The Kaplan-Meier method was used to compare overall survival and progression-free survival periods between the two groups, and the log-rank test determined that the differences were statistically significant. Statistical significance was set at a p-value less than 0.05. Calculation of propensity scores and selection of the matched cohort was performed using R (R Foundation for Statistical Computing, 2020) version 4.0.2 with the MatchIt package, and the rest of the statistical analyses were performed using SPSS 25.0. Results Baseline Data A total of 24 HIV-positive patients and 363 HIV-negative patients were included, and 72 patients were matched by propensity score (HIV-positive : HIV-negative = 24:48, Table 1 ). Although the differences in all variables were not statistically significant before and after matching, the differences in baseline data such as tumor site, degree of differentiation, T stage, and age became smaller after matching. Table 1 Comparison of baseline data before and after PSM Before PSM After PSM HIV-negative HIV-positive P value HIV-negative HIV-negative P value n = 363 n = 24 n = 48 n = 24 Sex 1.000 1.000 Male 211 (58.1%) 14 (58.3%) 29 (60.4%) 14 (58.3%) Female 152 (41.9%) 10 (41.7%) 19 (39.6%) 10 (41.7%) Age(years) 66.3 ± 10.6 63.6 ± 12.0 0.283 64.3 ± 12.4 63.6 ± 12.0 0.808 Tumor site 0.466 0.833 Proximal colon 126 (34.7%) 7 (29.2%) 11 (22.9%) 7 (29.2%) Distal colon 101 (27.8%) 5 (20.8%) 10 (20.8%) 5 (20.8%) Rectum 136 (37.5%) 12 (50.0%) 27 (56.2%) 12 (50.0%) Degree of differentiation 0.572 1.000 Low 36 (9.9%) 3 (12.5%) 6 (12.5%) 3 (12.5%) Middle 316 (87.1%) 20 (83.3%) 40 (83.3%) 20 (83.3%) High 11 (3.0%) 1 (4.2%) 2 (4.2%) 1 (4.2%) T stage 0.425 1.000 T1 18 (5.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) T2 53 (14.6%) 6 (25.0%) 13 (27.1%) 6 (25.0%) T3 200 (55.1%) 13 (54.2%) 25 (52.1%) 13 (54.2%) T4a 73 (20.1%) 3 (12.5%) 7 (14.6%) 3 (12.5%) T4b 19 (5.2%) 2 (8.3%) 3 (6.2%) 2 (8.3%) Variables are expressed as median (P25, P75) or n (%). PSM, Propensity score matching Basic features After propensity score matching, compared with HIV-negative patients, less HIV positive patients received chemotherapy [29.2% vs. 62.5, p = 0.008], while the differences in CRC family history, main complications, smoking, drinking, abdominal surgery history, BMI and adverse reaction of chemotherapy were not statistically significant (Table 2 ). Table 2 patient basic features of both groups HIV-positive(n = 24) HIV-negative(n = 48) P value CRC family history 1(4.2%) 5(10.4%) 0.656 Main comorbidity 8(33.3%) 18(37.5%) 0.729 Hypertension 4(16.7%) 11(22.9%) 0.538 Diabetes mellitus 2(8.3%) 8(16.7%) 0.479 CHD 4(16.7%) 5(10.4%) 0.469 COPD 0 2(4.2%) 0.549 Drinking 6(25%) 16(33.3%) 0.469 Smoking 4(16.7%) 11(22.9%) 0.538 Abdominal surgery History 5(20.8%) 8(16.7%) 0.749 BMI(Kg/m2) 22.06(19.71,23.95) 23.02(21.03,25.17) 0.074 Chemotherapy 7(29.2%) 30(62.5%) 0.008 Adverse reaction of chemotherapy 2(28.6%) 15(50%) 0.416 Fevera 0 0 NA Variables are expressed as median (P25, P75) or n (%). a Recurrent fever before or after surgery CRC, CRC; CHD, coronary atherosclerotic heart disease; COPD, chronic obstructive pulmonary disease; BMI, body mass index; ASA, American Society of Anesthesiologists; Post-operative outcomes Table 3 reports the major peripheral venous blood indicators of 72 patients. Compared to HIV-negative patients, HIV-positive patients had lower postoperative leukocyte [5.36(3.85,6.70) vs 5.92(4.95,7.50), p = 0.49], fewer postoperative leukocyte [6.91(5.36,8.84) vs 8.98(6.97,10.89), p = 0.013], fewer preoperative lymphocyte [1.19(0.77,1.48) vs 1.48(1.18,1.90), p = 0.028], lower CEA [2.27(1.38,3.10) vs 5.44(2.90,20.00), p = 0.012]. No significant differences emerged in preoperative and postoperative hemoglobin, postoperative lymphocytes, preoperative albumin, postoperative albumin, CA19-9, and ASA were statistically different. Surgical Safety between HIV + and HIV − groups are shown in Table 4 . HIV-positive patients had more intraoperative blood loss than HIV-negative patients [100(50,100) vs. 50(35,100), p = 0.46], but There was no difference between the two groups in the operation time, time to first flatus, time to first defecation, time to first liquid intake, time to ambulation, postoperative hospital stay, postoperative complications, admission to ICU, time to stopping antibiotics, hospitalization expenses, PS of one month after operation, long term postoperative gastrointestinal discomfort, decrease in hemoglobin, decrease in albumin, intraoperative blood transfusion, enterostomy, ASA score. 2 patients in each group had distant metastasis before operation, 1 patient in HIV positive group had liver and lung metastasis, and another 3 patients had only liver metastasis. There were no readmission and death within one month in both groups. The median follow-up time for both HIV-positive and matched controls was 31 months (2–91). 10 patients (41.7%) death (9 of cancer and 1 of others) in HIV-positive group compared to 7 patients (14.6%) death in the control group (6 of cancer and 1 of others). HIV-positive CRC patients had a reduced overall survival (26 months and 37 months, respectively) and progression free survival (21 months and 37 months, respectively). The differences in OS(p = 0.007) (Fig. 1 ) and PFS(p = 0.031) (Fig. 2 ) between the two groups were statistically significant. Table 3 Comparison of main test results between HIV-positive patients and HIV-negative patients HIV-positive(n = 24) HIV-negative(n = 48) P value Preoperative leukocyte(10^9) 5.36(3.85,6.70) 5.92(4.95,7.50) 0.049 Postoperative leukocyte(10^9) 6.91(5.36,8.84) 8.98(6.97,10.89 0.013 Preoperative hemoglobin(g/L) 123.50(101.25,139.75) 128.00(120.00,140.00) 0.229 Postoperative hemoglobin(g/L) 121.50(96.00,127.00) 119.00(107.25,125.25) 0.976 Preoperative lymphocyte(10^9) 1.19(0.77,1.48) 1.48(1.18,1.90) 0.028 Postoperative lymphocyte(10^9) 0.75(0.49,0.98) 0.79(0.61,1.07) 0.685 Preoperative albumin(g/L) 43.00(37.00,45.00) 41.00(38.00,44.00) 0.807 Postoperative albumin(g/L) 32.00(28.00,36.00) 29.00(25.00,34.75) 0.087 CEA(ug/L) 2.27(1.38,3.10) 5.44(2.90,20.00) 0.012 CA19-9(u/mL) 13.96(5.40,20.85) 15.00(6.99,34.68) 0.983 Variables are expressed as median (P25, P75) or n (%). Table 4 Comparison of surgical outcomes of both groups HIV-positive(n = 24) HIV-negative(n = 48) P value Intraoperative blood loss (mL) 100(50,100) 50(34,100) 0.046 Operation time (min) 187.50(151.25,227.25) 195.00(144.75,240.00) 0.77 Time to first flatus (days) 3(2,4) 3(2.25,6) 0.668 Time to first defecation (days) 3(1.25,4.75) 3(2,6) 0.257 Time to first liquid intake (days) 2.5(2,3) 3(2.25,4) 0.064 Time to ambulation (days) 3(3,6.25) 3.5(3,4) 0.98 Postoperative hospital stay (days) a 9(7,13.25) 8(7,11) 0.655 postoperative complications 3(12.5%) 5(10.4%) 1.000 Admitted to ICU 1(4.2%) 9(18.8%) 0.149 Time to stopping antibiotics (days) a 2(1,2.75) 2(1,3.75) 0.679 Hospitalization expenses (thousand yuan) a 78.7 (65.3,88.6) 81.4 (67.5,134.1) 0.173 PS of one month after operation 1(1,1) 1(1,1) 0.48 Long term postoperative gastrointestinal discomfort 8(33.3%) 12(25%) 0.457 Decrease in hemoglobin (g/L) a 11(0.5,18.75) 12(4,22) 0.385 Decrease in albumin (g/L) a 9.28(4.75,13.28) 12(7,15) 0.071 Intraoperative blood transfusion 1(4.2%) 1(2.1%) 1.000 Enterostomy 7(29.2%) 10(20.8%) 0.433 Readmission within one month 0 0 NA Death within one month 0 0 NA ASA score 3(2,3) 2(2,3) 0.713 Variables are expressed as median (P25, P75) or n (%). ASA, American Society of Anesthesiologists; ICU, Intensive Care Unit Oncological features HIV-positive patients had more lymph node metastases than HIV-negative patients [1(0,3.5) vs 0(0,0), p = 0.001], higher N-stage [1(0,1.75) vs 0(0,1), p = 0.005], and higher TNM stage [3(2,3) vs 2(2,2.75), p = 0.004], while the harvested lymph nodes, size of the largest lymph node, metastasis, tumor size, MSI, RAS gene mutation, BRAF gene mutation, MLH1, MSH2, MSH6, and Ki-67 were not statistically significant. There were no cases with positive margins in both groups (Table 5 ). Table 5 Patient tumor features of both groups HIV-positive(n = 24) HIV-negative(n = 48) P value No. of metastatic lymph nodes 1(0,3.5) 0(0,0) 0.001 N stage 1(0,1.75) 0(0,1) 0.005 Harvested lymph nodes 13(10,15.75) 14.5(11.25,18) 0.223 Size of the largest lymph node 0.85(0.525,1.45) 0.8(0.5,1) 0.318 Metastasis 2(8.3%) 2(4.2%) 0.597 TNM stage 3(2,3) 2(2,2.75) 0.004 Tumor size (cm) 3.75(2.5,5) 4(3,5) 0.497 Margin 0 0 NA MSI 1(11.1%) 1(6.3%) 1 RAS gene mutation 3(37.5%) 13(76.5%) 0.087 BRAF gene mutation 0 1(5.8%) 1 MLH1 14(82.4%) 35(92.1%) 0.359 MSH2 16(94.1%) 37(97.4%) 0.527 MSH6 16(94.1%) 37(97.4%) 0.527 Ki-67 (%) 70(60,80) 60(50,80) 0.159 Variables are expressed as median (P25, P75) or n (%). MSI, Microsatellite instability. Discussion To our knowledge, there are no studies reporting the differences in postoperative pathological features between patients with HIV-combined CRC and patients with CRC alone with the same T stage and the same tumor site. In this study, after matching factors that may affect lymph node metastasis in CRC by PSM, by comparing HIV-positive CRC patients with the same T stage and the same tumor site with HIV-negative patients oncologic features, surgical safety and prognosis, we found that HIV-positive patients had significantly more lymph node metastases than HIV-negative patients (Table 5), in addition, HIV-positive patients had higher N stage and TNM stage than HIV-negative patients. In terms of surgical safety, although HIV-positive patients had more intraoperative blood loss than HIV-negative patients, the difference in decrease in hemoglobin between the two groups was not statistically significant, and intraoperative blood loss was the expected value for the attending surgeon, so we concluded that the surgical safety of radical CRC surgery in HIV-positive patients was not worse than that in HIV-negative patients. But the OS and PFS were shorter in HIV-positive patients compared with HIV-negative patients. Strangely, we found that the CEA of HIV positive colorectal cancer patients is lower than that of HIV negative patients. The amount of CEA produced in normal tissues and cancer tissues is roughly the same[12, 13]. Every day, healthy adults excrete about 50-70mg of CEA in their feces[12]. It can be seen that most of the CEA produced by the human body is excreted through the intestine. CEA may have the function of innate immunity[14, 15] and may prevent microorganisms from invading intestinal epithelial cells[15]. However, due to immune deficiency, the intestinal mucosa of HIV infected people has decreased resistance to intestinal flora, resulting in more CEA released into the intestine to resist microorganisms, so the level of CEA in the blood decreases. There is controversy as to whether HIV increases the risk of CRC. Although most studies suggest that HIV decreases immunity and HARRT therapy increases life expectancy in HIV-positive patients, leading to an increased risk of malignancy in HIV-positive patients[6, 7, 16, 17]. Some literature reports no difference in the prevalence of CRC between HIV-positive and HIV-negative patients[18]. Some literature even suggests that HIV-positive patients have a lower risk of CRC[19]. Reinhold et al. [16]found that HIV-positive patients were less likely to undergo any CRC screening tests compared to uninfected subjects. This may account for the lower risk of CRC found in HIV-positive patients in some studies. In addition, we found that HIV-positive patients were less likely to receive chemotherapy than HIV-negative patients, which is similar to the results of the studies by Suneja et al[20, 21]. Differences in access to cancer treatment may partially explain the shorter survival of HIV-infected cancer patients. Suneja et al. suggest that many treatment provider-level factors, such as providers' possible belief that HIV-positive patients are in poorer organismal condition, less tolerant of treatment, and that HIV-infected patients are less likely to adhere to treatment compared to HIV-negative patients leading to HIV-positive patients being the likelihood of HIV-positive patients receiving systemic therapy is reduced. In addition, the lack of specific treatment guidelines for HIV-infected cancer patients is also an important reason for the low proportion of HIV-positive patients receiving systemic therapy[21]. From the patient's perspective, it may be that HIV-infected patients are more reluctant to receive systemic therapy for oncology because of concerns about chemotherapy side effects, inadequate understanding of the need for cancer treatment, or the burden of dual management of cancer and HIV[20]. Available data suggest that HIV-infected CRC patients are more severely ill and younger than those without HIV infection[9]. Berretta et al.[22] compared the clinical presentation and outcomes of 27 HIV-positive patients and 54 age- and sex-matched CRC controls, who concluded that HIV-positive patients had poorer PS and unfavorable Dukes stage. Bini et al.[9] published the results of a screening colonoscopy study that assessed the prevalence of colon cancer in 136 asymptomatic HIV infected subjects ≥ 50 years old and 272 asymptomatic uninfected controls with colorectal cancer by matching age, sex and CRC family history. The authors found that the prevalence of neoplastic lesions was significantly higher in HIV-infected subjects than in controls, even after adjusting for potential confounding variables. In this study, after PSM, although there was no significant difference in age between HIV-positive and HIV-negative patients, the number of metastatic lymph nodes in HIV-positive patients was significantly more than that in HIV-negative patients, and the OS and PFS of HIV-positive patients were significantly shorter than those of HIV-negative patients. This is consistent with the findings of Berretta et al. Although this is a retrospective study, we used PSM to reduce the difference in baseline data between the two groups of patients and to minimize the impact of baseline differences on the results. This in turn allowed a better comparison of the postoperative oncologic features, surgical safety and prognosis between HIV-positive and HIV-negative CRC patients undergoing radical CRC resection at the same T-stage and at the same tumor site. The present study still has some shortcomings. First, the sample size of this study is small and more cases in the experimental group are not available at present, and we hope to expand the sample size for further study in the future; second, some data collection in this study is incomplete, some patients did not undergo genetic testing or immunohistochemistry, resulting in some missing data of MSI, RAS, BRAF, MHL1, MSH2, MSH6, Ki-67, massive loss of CD4 and CD8 levels during perioperative period in HIV positive patients, so this data was not analyzed in this study. Conclusion compared with HIV-negative CRC patients, HIV-positive patients with the same T-stage and the same tumor site have a higher number of lymph node metastases and worse postoperative long-term survival, but the risk of surgery is not increased. Declarations Ethics approval and consent to participate Approval of the research protocol: This study was reviewed and approved by the Medical Ethics Committee of Chongqing Medical University. The Ethics number: K2023-019. All methods were carried out in accordance with the Declaration of Helsinki. We state that informed consent was obtained from all subjects and/or their legal guardian(s). Consent for publication Not applicable. Availability of data and materials The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. Competing interests The authors declare that they have no conflict of interest. Funding Not applicable. Authors’ Contributions FY contributed to the conception and design of the study. KQ provided the study materials and patients. DC and CT collected and assembled data. FY wrote the first draft of the manuscript. SW、FH and YL contributed to the manuscript modification. All authors contributed to the manuscript revision and read and approved the submitted version. Acknowledgments The authors are grateful to all their colleagues who helped prepare this article. We thank Yi Xiao for his diligence in data entry. References Shiels, M.S and E.A Engels, Evolving epidemiology of HIV-associated malignancies Current Opinion in HIV and AIDS, 2017 12(1): p 6-11. Nasti, G., et al., Impact of highly active antiretroviral therapy on the presenting features and outcome of patients with acquired immunodeficiency syndrome-related Kaposi sarcoma Cancer, 2003 98(11): p 2440-2446. Berretta, M., et al., Therapeutic approaches to AIDS-related malignancies Oncogene, 2003 22(42): p 6646-6659. Martellotta, F., et al., AIDS-related Kaposi's sarcoma: state of the art and therapeutic strategies Curr HIV Res, 2009 7(6): p 634-8. Simard, E.P and E.A Engels, Cancer as a cause of death among people with AIDS in the United States Clin Infect Dis, 2010 51(8): p 957-62. Shiels, M.S., et al., A Meta-Analysis of the Incidence of Non-AIDS Cancers in HIV-Infected Individuals JAIDS Journal of Acquired Immune Deficiency Syndromes, 2009 52(5): p 611-622. Kan, M., et al., Colorectal and anal cancer in HIV/AIDS patients: a comprehensive review Expert Rev Anticancer Ther, 2014 14(4): p 395-405. Sung, H., et al., Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries CA: A Cancer Journal for Clinicians, 2021 71(3): p 209-249. Bini, E.J., B Green and M.A Poles, Screening colonoscopy for the detection of neoplastic lesions in asymptomatic HIV-infected subjects Gut, 2009 58(8): p 1129-1134. Reiffel, J.A., Propensity Score Matching: The ‘Devil is in the Details’ Where More May Be Hidden than You Know The American Journal of Medicine, 2020 133(2): p 178-181. Austin, P.C., Balance diagnostics for comparing the distribution of baseline covariates between treatment groups in propensity-score matched samples Statistics in Medicine, 2009 28(25): p 3083-3107. Matsuoka, Y., et al., Highly Effective Extraction of Carcinoembryonic Antigen with Phosphatidylinositol-Specific Phospholipase C Tumor biology, 1991 12(2): p 91-98. Kinugasa, T., et al., Non-proteolytic release of carcinoembryonic antigen from normal human colonic epithelial cells cultured in collagen gel Int J Cancer, 1994 58(1): p 102-7. Virji, M., CEA and innate immunity Trends Microbiol, 2001 9(6): p 258-9. Hammarstrom, S., The carcinoembryonic antigen (CEA) family: structures, suggested functions and expression in normal and malignant tissues Semin Cancer Biol, 1999 9(2): p 67-81. Reinhold, J., et al., Colorectal Cancer Screening in HIV-Infected Patients 50 Years of Age and Older: Missed Opportunities for Prevention The American Journal of Gastroenterology, 2005 100(8): p 1805-1812. Dal Maso, L., D Serraino and S Franceschi, Epidemiology of AIDS-related tumours in developed and developing countries Eur J Cancer, 2001 37(10): p 1188-201. Faqih, A., et al., Colorectal Neoplasia among Patients with and without Human Immunodeficiency Virus Cancer Epidemiology, Biomarkers & Prevention, 2020 29(8): p 1689-1691. Coghill, A.E., et al., Risk of Breast, Prostate, and Colorectal Cancer Diagnoses Among HIV-Infected Individuals in the United States J Natl Cancer Inst, 2018 110(9): p 959-966. SUNEJA, G., et al Cancer Treatment Disparities in HIV-Infected Individuals in the United States 2014 Alexandria, VA: American Society of Clinical Oncology. Suneja, G., et al., Cancer Treatment in Patients With HIV Infection and Non-AIDS-Defining Cancers: A Survey of US Oncologists J Oncol Pract, 2015 11(3): p e380-7. Berretta, M., et al., Clinical Presentation and Outcome of Colorectal Cancer in HIV-Positive Patients: A Clinical Case-Control Study Onkologie, 2009 32(6): p 319-324. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-2556602","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":176242286,"identity":"9c0101fc-f22b-40c0-8e01-287b3d650360","order_by":0,"name":"Fuyu Yang","email":"","orcid":"","institution":"The First Affiliated Hospital of Chongqing Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Fuyu","middleName":"","lastName":"Yang","suffix":""},{"id":176242288,"identity":"11e61c86-7635-41e2-bb21-809eff069a16","order_by":1,"name":"Defei Chen","email":"","orcid":"","institution":"The First Affiliated Hospital of Chongqing Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Defei","middleName":"","lastName":"Chen","suffix":""},{"id":176242289,"identity":"3619db2c-1bec-457c-8f75-051eede8c202","order_by":2,"name":"Saed Woraikat","email":"","orcid":"","institution":"The First Affiliated Hospital of Chongqing Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Saed","middleName":"","lastName":"Woraikat","suffix":""},{"id":176242290,"identity":"37a3590b-728d-42ea-adbd-ea1caf3b0253","order_by":3,"name":"Chenglin Tang","email":"","orcid":"","institution":"The First Affiliated Hospital of Chongqing Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Chenglin","middleName":"","lastName":"Tang","suffix":""},{"id":176242291,"identity":"6c80aba5-4300-4baa-8020-eaa9ab67ce56","order_by":4,"name":"Fan He","email":"","orcid":"","institution":"The First Affiliated Hospital of Chongqing Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Fan","middleName":"","lastName":"He","suffix":""},{"id":176242292,"identity":"27d4422b-7997-4daf-8b79-9cc823723b31","order_by":5,"name":"Yao Li","email":"","orcid":"","institution":"Chongqing Public Health Medical Center","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Yao","middleName":"","lastName":"Li","suffix":""},{"id":176242293,"identity":"7f090c56-13eb-4df2-a656-2ae8fec8cc4d","order_by":6,"name":"Kun Qian","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA0ElEQVRIiWNgGAWjYBACgwMMCQwMB2wSwLyEAuK1pCUwsIG0GBCnBQgOHIZoYSBKy42Exx/enDmfxy/fnfjhgQGDPL/YAfxa7M8cSJOcc+N2sWQb72YJoMMMZ85OIGDL8YY0Zp4PtxM3HOPdANKSYHCbkJbDDMmfeT6cA2nZ/IM4LccbEqR5bhwAadlGpC1gv5xJTpzZlrvNIsFAggi/3MhJ/vDmmF1iP/PZzTd/VNjI80sT0MLAwJPAwIPgSRBSDgLsB5C1jIJRMApGwSjABAAI101/3fy5OQAAAABJRU5ErkJggg==","orcid":"","institution":"The First Affiliated Hospital of Chongqing Medical University","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Kun","middleName":"","lastName":"Qian","suffix":""}],"badges":[],"createdAt":"2023-02-06 15:14:26","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-2556602/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-2556602/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":33049503,"identity":"2bf5f6d0-ee4e-4753-8cc0-18ff4c83ee85","added_by":"auto","created_at":"2023-02-16 20:06:21","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":45302,"visible":true,"origin":"","legend":"\u003cp\u003eOS for colorectal carcinoma in HIV+ patients and HIV- controls with corresponding P value.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-2556602/v1/d61a907fd55ac55d0d0eca02.png"},{"id":33049504,"identity":"cc863f55-b3b8-43f7-8eea-6f265a8a5166","added_by":"auto","created_at":"2023-02-16 20:06:21","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":46359,"visible":true,"origin":"","legend":"\u003cp\u003ePFS for colorectal carcinoma in HIV+ patients and HIV- controls with corresponding P value.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-2556602/v1/625bde62d71379dd085f30b9.png"},{"id":39150782,"identity":"8e92eeaf-84d3-45a2-a5d8-097be40b7124","added_by":"auto","created_at":"2023-06-27 08:14:33","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":412470,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-2556602/v1/fdd3e354-e887-479d-8675-1b76777f4d8e.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Oncological Features and Prognosis of HIV-positive Colorectal Cancer: An analysis using propensity score matching","fulltext":[{"header":"Introduction","content":"\u003cp\u003eSince 1996, since Acquired Immune Deficiency Syndrome (AIDS) patients generally accepted highly active antiretroviral therapy (HAART), the survival period of patients has significantly prolonged, and the incidence rate of AIDS defined cancers, Kaposi's sarcoma, non-Hodgkin lymphoma and cervical cancer has significantly decreased[\u003cspan additionalcitationids=\"CR2 CR3 CR4\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. However, the incidence rate of non-AIDS-defining cancers (NADCs), such as CRC, liver cancer, lung cancer, anal cancer, and Hodgkin's disease has increased[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e], which is related to the prolongation of life expectancy of AIDS patients. These NADCs account for an increasing proportion of deaths of HIV carriers. According to GLOBOCAN 2020[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e] data, there was about 1.93\u0026nbsp;million new cases of CRC in the world in 2020, ranking third in malignant tumors (10.0%), only after breast cancer (11.7%) and lung cancer (11.4%); About 930000 (9.4%) people died, only after lung cancer (18.0%), ranking second in malignant tumors. The number of new cases and deaths of CRC in the world are increasing year by year. Compared with the general population, AIDS patients not only have an increased incidence rate of CRC, the age of invasion is earlier, but also their performance will be more advanced[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eDuring the operation, our team found that there seemed to be more suspicious positive lymph nodes in CRC patients with HIV infection. However, under the same T stage and the same tumor site, the differences in oncological features and prognosis between HIV positive CRC patients and HIV negative patients were rarely reported. With the prolongation of life expectancy of HIV infected people and the increased risk of CRC among HIV infected people, it is very important to understand the prognosis and pathological features of CRC in HIV positive patients. Therefore, this study intends to compare the differences in oncological features, surgical safety and prognosis between HIV positive CRC patients and HIV negative CRC patients at the same T stage and the same tumor site.\u003c/p\u003e"},{"header":"Materials And Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003ePatients and methods\u003c/h2\u003e \u003cp\u003eWe searched the clinical data of patients who were diagnosed as CRC complicated with HIV infection and underwent radical CRC resection from January 1, 2012 to March 31, 2022. A total of 24 cases were retrieved. After analysis, we found that the pathological classification of all HIV positive CRC patients was adenocarcinoma, and no preoperative neoadjuvant chemotherapy or radiotherapy was performed. Because our hospital has more than 1000 CRC radical operations every year, if we collect the clinical data of all patients, the workload is huge, so we use the method of random stratified sampling, we collect 363 patients who haven\u0026rsquo;t received preoperative neoadjuvant chemotherapy and radiotherapy, HIV negative colorectal adenocarcinoma and have undergone radical CRC resection.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eData collection and definition\u003c/h2\u003e \u003cp\u003eWe collected baseline data, perioperative indicators, oncological features and long-term postoperative data of patients. The baseline data include: 1. Basic information of patients: age, sex, tumor site (according to the International Classification of Diseases for Oncology, the tumor site of CRC is divided into proximal colon (ICD-O3C180-84), distal colon (ICD-O3C185-87) and rectum (ICD-O3C199, C209)), degree of differentiation, T stage, CRC family history, main complications (hypertension, diabetes, CHD(coronary atherosclerotic heart disease), COPD(chronic obstructive pulmonary disease)), smoking, drinking, abdominal surgery history, BMI(body mass index), chemotherapy and adverse reaction of chemotherapy. 2. Perioperative indicators: preoperative and postoperative leukocyte, hemoglobin, lymphocyte, albumin, preoperative CEA, CA19-9, intraoperative blood loss, operation time, time to first flatus, time to first defecation, time to first liquid intake, time to ambulation, postoperative hospital stay, postoperative complications (including postoperative bleeding, anastomotic leakage, wound infection, pulmonary infection, abdominal cavity infection,, urinary infection, retention of urine, lower limb deep vein thrombosis), admission to ICU, time to stopping antibiotics, hospitalization expenses, PS of one month after operation, decrease in hemoglobin, decrease in albumin, intraoperative blood transfusion, enterostomy, readmission within one month, death within one month, ASA score. 3. Oncological features: No. of metastatic lymph nodes, N stage, harvested lymph nodes, size of the largest lymph node(the longest diameter of the largest lymph node), metastasis, TNM stage, tumor size, margin, MSI, RAS gene mutation, BRAF gene mutation, MLH1, MSH2 MSH6 Ki-67. 4. Postoperative long-term data: progression free survival period, cause of death, postoperative long-term gastrointestinal discomfort (diarrhea, Dyssynergic defecation, abdominalgia, abdominal distension), and recurrent fever before or after surgery.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003ePropensity score matching (PSM) analysis is widely used because of its ability to minimize intervention or patient selection bias in non-randomized controlled or observational studies[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. To reduce the impact of differences in baseline data between HIV positive and HIV negative patients on the results, especially the effect on the number of metastatic lymph nodes., we used PSM to pair HIV-positive and HIV-negative patients. We included a cohort of patients with nearly 15 times as many HIV-negative patients as HIV-positive patients before matching, and matching at 1:1 would have resulted in substantial data loss and reduced statistical power. Therefore, we matched at 1:2. Variables that may affect the number of peri-intestinal lymph node metastases and baseline data were used to construct propensity scores: age, sex, tumor site, degree of tumor differentiation, and T stage. The Matching package was used to match the data for propensity scores, and 1:2 matching was adopted, with the caliper width limit to 0.1*standard deviation of the logarithmic score, and the matched groups were considered balanced if the standardized mean difference (SMD) of the difference between them after matching was less than 0.1[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Categorical variables were expressed as frequency (%) and continuous variables were expressed as median (P25, P75). Categorical variables were analysed by Fisher\u0026rsquo;s exact or chi-square test and continuous variables by Mann-Whitney U test. P value less than 0.05 was considered statistically significant. The Kaplan-Meier method was used to compare overall survival and progression-free survival periods between the two groups, and the log-rank test determined that the differences were statistically significant. Statistical significance was set at a p-value less than 0.05. Calculation of propensity scores and selection of the matched cohort was performed using R (R Foundation for Statistical Computing, 2020) version 4.0.2 with the MatchIt package, and the rest of the statistical analyses were performed using SPSS 25.0.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eBaseline Data\u003c/h2\u003e \u003cp\u003eA total of 24 HIV-positive patients and 363 HIV-negative patients were included, and 72 patients were matched by propensity score (HIV-positive : HIV-negative\u0026thinsp;=\u0026thinsp;24:48, Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Although the differences in all variables were not statistically significant before and after matching, the differences in baseline data such as tumor site, degree of differentiation, T stage, and age became smaller after matching.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of baseline data before and after PSM\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eBefore PSM\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eAfter PSM\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHIV-negative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHIV-positive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eHIV-negative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eHIV-negative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;363\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e211 (58.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14 (58.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e29 (60.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e14 (58.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e152 (41.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (41.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e19 (39.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10 (41.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge(years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e66.3\u0026thinsp;\u0026plusmn;\u0026thinsp;10.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e63.6\u0026thinsp;\u0026plusmn;\u0026thinsp;12.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.283\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e64.3\u0026thinsp;\u0026plusmn;\u0026thinsp;12.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e63.6\u0026thinsp;\u0026plusmn;\u0026thinsp;12.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.808\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTumor site\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.466\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.833\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProximal colon\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e126 (34.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7 (29.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11 (22.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7 (29.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDistal colon\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e101 (27.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (20.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10 (20.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5 (20.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRectum\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e136 (37.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12 (50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e27 (56.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e12 (50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDegree of differentiation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.572\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36 (9.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (12.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6 (12.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3 (12.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMiddle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e316 (87.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20 (83.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e40 (83.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e20 (83.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11 (3.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (4.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2 (4.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 (4.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eT stage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.425\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eT1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18 (5.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eT2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e53 (14.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (25.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13 (27.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6 (25.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eT3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e200 (55.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13 (54.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25 (52.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e13 (54.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eT4a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e73 (20.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (12.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7 (14.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3 (12.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eT4b\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19 (5.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (8.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3 (6.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2 (8.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003eVariables are expressed as median (P25, P75) or n (%).\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003ePSM, Propensity score matching\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eBasic features\u003c/h2\u003e \u003cp\u003eAfter propensity score matching, compared with HIV-negative patients, less HIV positive patients received chemotherapy [29.2% vs. 62.5, p\u0026thinsp;=\u0026thinsp;0.008], while the differences in CRC family history, main complications, smoking, drinking, abdominal surgery history, BMI and adverse reaction of chemotherapy were not statistically significant (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003epatient basic features of both groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHIV-positive(n\u0026thinsp;=\u0026thinsp;24)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHIV-negative(n\u0026thinsp;=\u0026thinsp;48)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCRC family history\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1(4.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5(10.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.656\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMain comorbidity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8(33.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18(37.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.729\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHypertension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4(16.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11(22.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.538\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiabetes mellitus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2(8.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8(16.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.479\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCHD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4(16.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5(10.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.469\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCOPD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2(4.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.549\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDrinking\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6(25%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16(33.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.469\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSmoking\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4(16.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11(22.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.538\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAbdominal surgery History\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5(20.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8(16.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.749\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI(Kg/m2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22.06(19.71,23.95)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.02(21.03,25.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.074\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChemotherapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7(29.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30(62.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.008\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdverse reaction of chemotherapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2(28.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15(50%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.416\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFevera\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eVariables are expressed as median (P25, P75) or n (%).\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e\u003csup\u003ea\u003c/sup\u003eRecurrent fever before or after surgery\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eCRC, CRC; CHD, coronary atherosclerotic heart disease; COPD, chronic obstructive pulmonary disease; BMI, body mass index; ASA, American Society of Anesthesiologists;\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003ePost-operative outcomes\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e reports the major peripheral venous blood indicators of 72 patients. Compared to HIV-negative patients, HIV-positive patients had lower postoperative leukocyte [5.36(3.85,6.70) vs 5.92(4.95,7.50), p\u0026thinsp;=\u0026thinsp;0.49], fewer postoperative leukocyte [6.91(5.36,8.84) vs 8.98(6.97,10.89), p\u0026thinsp;=\u0026thinsp;0.013], fewer preoperative lymphocyte [1.19(0.77,1.48) vs 1.48(1.18,1.90), p\u0026thinsp;=\u0026thinsp;0.028], lower CEA [2.27(1.38,3.10) vs 5.44(2.90,20.00), p\u0026thinsp;=\u0026thinsp;0.012]. No significant differences emerged in preoperative and postoperative hemoglobin, postoperative lymphocytes, preoperative albumin, postoperative albumin, CA19-9, and ASA were statistically different. Surgical Safety between HIV\u003csup\u003e+\u003c/sup\u003e and HIV\u003csup\u003e\u0026minus;\u003c/sup\u003e groups are shown in Table \u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e. HIV-positive patients had more intraoperative blood loss than HIV-negative patients [100(50,100) vs. 50(35,100), p\u0026thinsp;=\u0026thinsp;0.46], but There was no difference between the two groups in the operation time, time to first flatus, time to first defecation, time to first liquid intake, time to ambulation, postoperative hospital stay, postoperative complications, admission to ICU, time to stopping antibiotics, hospitalization expenses, PS of one month after operation, long term postoperative gastrointestinal discomfort, decrease in hemoglobin, decrease in albumin, intraoperative blood transfusion, enterostomy, ASA score. 2 patients in each group had distant metastasis before operation, 1 patient in HIV positive group had liver and lung metastasis, and another 3 patients had only liver metastasis. There were no readmission and death within one month in both groups. The median follow-up time for both HIV-positive and matched controls was 31 months (2\u0026ndash;91). 10 patients (41.7%) death (9 of cancer and 1 of others) in HIV-positive group compared to 7 patients (14.6%) death in the control group (6 of cancer and 1 of others). HIV-positive CRC patients had a reduced overall survival (26 months and 37 months, respectively) and progression free survival (21 months and 37 months, respectively). The differences in OS(p\u0026thinsp;=\u0026thinsp;0.007) (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e) and PFS(p\u0026thinsp;=\u0026thinsp;0.031) (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e) between the two groups were statistically significant.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of main test results between HIV-positive patients and HIV-negative patients\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHIV-positive(n\u0026thinsp;=\u0026thinsp;24)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHIV-negative(n\u0026thinsp;=\u0026thinsp;48)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePreoperative leukocyte(10^9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5.36(3.85,6.70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.92(4.95,7.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.049\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePostoperative leukocyte(10^9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6.91(5.36,8.84)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.98(6.97,10.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.013\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePreoperative hemoglobin(g/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e123.50(101.25,139.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e128.00(120.00,140.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.229\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePostoperative hemoglobin(g/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e121.50(96.00,127.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e119.00(107.25,125.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.976\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePreoperative lymphocyte(10^9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.19(0.77,1.48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.48(1.18,1.90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.028\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePostoperative lymphocyte(10^9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.75(0.49,0.98)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.79(0.61,1.07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.685\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePreoperative albumin(g/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e43.00(37.00,45.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e41.00(38.00,44.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.807\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePostoperative albumin(g/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e32.00(28.00,36.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e29.00(25.00,34.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.087\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCEA(ug/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.27(1.38,3.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.44(2.90,20.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.012\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCA19-9(u/mL)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13.96(5.40,20.85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15.00(6.99,34.68)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.983\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eVariables are expressed as median (P25, P75) or n (%).\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of surgical outcomes of both groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHIV-positive(n\u0026thinsp;=\u0026thinsp;24)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHIV-negative(n\u0026thinsp;=\u0026thinsp;48)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntraoperative blood loss (mL)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e100(50,100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50(34,100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.046\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOperation time (min)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e187.50(151.25,227.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e195.00(144.75,240.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.77\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTime to first flatus (days)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3(2,4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3(2.25,6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.668\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTime to first defecation (days)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3(1.25,4.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3(2,6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.257\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTime to first liquid intake (days)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.5(2,3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3(2.25,4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.064\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTime to ambulation (days)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3(3,6.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.5(3,4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.98\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePostoperative hospital stay (days) a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9(7,13.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8(7,11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.655\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003epostoperative complications\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3(12.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5(10.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdmitted to ICU\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1(4.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9(18.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.149\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTime to stopping antibiotics (days) a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2(1,2.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2(1,3.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.679\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHospitalization expenses (thousand yuan) a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e78.7 (65.3,88.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e81.4 (67.5,134.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.173\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePS of one month after operation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1(1,1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1(1,1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.48\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLong term postoperative gastrointestinal discomfort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8(33.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12(25%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.457\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDecrease in hemoglobin (g/L) a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11(0.5,18.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12(4,22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.385\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDecrease in albumin (g/L) a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9.28(4.75,13.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12(7,15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.071\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntraoperative blood transfusion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1(4.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1(2.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEnterostomy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7(29.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10(20.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.433\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReadmission within one month\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDeath within one month\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eASA score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3(2,3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2(2,3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.713\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eVariables are expressed as median (P25, P75) or n (%).\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eASA, American Society of Anesthesiologists; ICU, Intensive Care Unit\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eOncological features\u003c/h2\u003e \u003cp\u003eHIV-positive patients had more lymph node metastases than HIV-negative patients [1(0,3.5) vs 0(0,0), p\u0026thinsp;=\u0026thinsp;0.001], higher N-stage [1(0,1.75) vs 0(0,1), p\u0026thinsp;=\u0026thinsp;0.005], and higher TNM stage [3(2,3) vs 2(2,2.75), p\u0026thinsp;=\u0026thinsp;0.004], while the harvested lymph nodes, size of the largest lymph node, metastasis, tumor size, MSI, RAS gene mutation, BRAF gene mutation, MLH1, MSH2, MSH6, and Ki-67 were not statistically significant. There were no cases with positive margins in both groups (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePatient tumor features of both groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHIV-positive(n\u0026thinsp;=\u0026thinsp;24)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHIV-negative(n\u0026thinsp;=\u0026thinsp;48)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo. of metastatic lymph nodes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1(0,3.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0(0,0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN stage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1(0,1.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0(0,1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.005\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHarvested lymph nodes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13(10,15.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.5(11.25,18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.223\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSize of the largest lymph node\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.85(0.525,1.45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.8(0.5,1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.318\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMetastasis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2(8.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2(4.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.597\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTNM stage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3(2,3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2(2,2.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTumor size (cm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.75(2.5,5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4(3,5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.497\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMargin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMSI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1(11.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1(6.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRAS gene mutation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3(37.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13(76.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.087\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBRAF gene mutation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1(5.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMLH1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14(82.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35(92.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.359\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMSH2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16(94.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37(97.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.527\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMSH6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16(94.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37(97.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.527\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKi-67 (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e70(60,80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60(50,80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.159\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eVariables are expressed as median (P25, P75) or n (%).\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eMSI, Microsatellite instability.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eTo our knowledge, there are no studies reporting the differences in postoperative pathological features between patients with HIV-combined CRC and patients with CRC alone with the same T stage and the same tumor site. In this study, after matching factors that may affect lymph node metastasis in CRC by PSM, by comparing HIV-positive CRC patients with the same T stage and the same tumor site with HIV-negative patients oncologic features, surgical safety and prognosis, we found that HIV-positive patients had significantly more lymph node metastases than HIV-negative patients (Table 5), in addition, HIV-positive patients had higher N stage and TNM stage than HIV-negative patients. In terms of surgical safety, although HIV-positive patients had more intraoperative blood loss than HIV-negative patients, the difference in decrease in hemoglobin between the two groups was not statistically significant, and intraoperative blood loss was the expected value for the attending surgeon, so we concluded that the surgical safety of radical CRC surgery in HIV-positive patients was not worse than that in HIV-negative patients. But the OS and PFS were shorter in HIV-positive patients compared with HIV-negative patients. Strangely, we found that the CEA of HIV positive colorectal cancer patients is lower than that of HIV negative patients. The amount of CEA produced in normal tissues and cancer tissues is roughly the same[12, 13]. Every day, healthy adults excrete about 50-70mg of CEA in their feces[12]. It can be seen that most of the CEA produced by the human body is excreted through the intestine. CEA may have the function of innate immunity[14, 15]\u0026nbsp;and may prevent microorganisms from invading intestinal epithelial cells[15]. However, due to immune deficiency, the intestinal mucosa of HIV infected people has decreased resistance to intestinal flora, resulting in more CEA released into the intestine to resist microorganisms, so the level of CEA in the blood decreases.\u003c/p\u003e\n\u003cp\u003eThere is controversy as to whether HIV increases the risk of CRC. Although most studies suggest that HIV decreases immunity and HARRT therapy increases life expectancy in HIV-positive patients, leading to an increased risk of malignancy in HIV-positive patients[6, 7, 16, 17]. Some literature reports no difference in the prevalence of CRC between HIV-positive and HIV-negative patients[18]. Some literature even suggests that HIV-positive patients have a lower risk of CRC[19]. Reinhold et al.\u0026nbsp;[16]found that HIV-positive patients were less likely to undergo any CRC screening tests compared to uninfected subjects. This may account for the lower risk of CRC found in HIV-positive patients in some studies. In addition, we found that HIV-positive patients were less likely to receive chemotherapy than HIV-negative patients, which is similar to the results of the studies by Suneja et al[20, 21]. Differences in access to cancer treatment may partially explain the shorter survival of HIV-infected cancer patients. Suneja et al. suggest that many treatment provider-level factors, such as providers\u0026apos; possible belief that HIV-positive patients are in poorer organismal condition, less tolerant of treatment, and that HIV-infected patients are less likely to adhere to treatment compared to HIV-negative patients leading to HIV-positive patients being the likelihood of HIV-positive patients receiving systemic therapy is reduced. In addition, the lack of specific treatment guidelines for HIV-infected cancer patients is also an important reason for the low proportion of HIV-positive patients receiving systemic therapy[21]. From the patient\u0026apos;s perspective, it may be that HIV-infected patients are more reluctant to receive systemic therapy for oncology because of concerns about chemotherapy side effects, inadequate understanding of the need for cancer treatment, or the burden of dual management of cancer and HIV[20].\u003c/p\u003e\n\u003cp\u003eAvailable data suggest that HIV-infected CRC patients are more severely ill and younger than those without HIV infection[9]. Berretta et al.[22]\u0026nbsp;compared the clinical presentation and outcomes of 27 HIV-positive patients and 54 age- and sex-matched CRC controls, who concluded that HIV-positive patients had poorer PS and unfavorable Dukes stage. Bini et al.[9]\u0026nbsp;published the results of a screening colonoscopy study that assessed the prevalence of colon cancer in 136 asymptomatic HIV infected subjects\u0026nbsp;\u0026ge;\u0026nbsp;50 years old and 272 asymptomatic uninfected controls with colorectal cancer by matching age, sex and CRC family history. The authors found that the prevalence of neoplastic lesions was significantly higher in HIV-infected subjects than in controls, even after adjusting for potential confounding variables. In this study, after PSM, although there was no significant difference in age between HIV-positive and HIV-negative patients, the number of metastatic lymph nodes in HIV-positive patients was significantly more than that in HIV-negative patients, and the OS and PFS of HIV-positive patients were significantly shorter than those of HIV-negative patients. This is consistent with the findings of Berretta et al.\u003c/p\u003e\n\u003cp\u003eAlthough this is a retrospective study, we used PSM to reduce the difference in baseline data between the two groups of patients and to minimize the impact of baseline differences on the results. This in turn allowed a better comparison of the postoperative oncologic features, surgical safety and prognosis between HIV-positive and HIV-negative CRC patients undergoing radical CRC resection at the same T-stage and at the same tumor site.\u003c/p\u003e\n\u003cp\u003eThe present study still has some shortcomings. First, the sample size of this study is small and more cases in the experimental group are not available at present, and we hope to expand the sample size for further study in the future; second, some data collection in this study is incomplete, some patients did not undergo genetic testing or immunohistochemistry, resulting in some missing data of MSI, RAS, BRAF, MHL1, MSH2, MSH6, Ki-67, massive loss of CD4 and CD8 levels during perioperative period in HIV positive patients, so this data was not analyzed in this study.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003ecompared with HIV-negative CRC patients, HIV-positive patients with the same T-stage and the same tumor site have a higher number of lymph node metastases and worse postoperative long-term survival, but the risk of surgery is not increased.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003e\u003cem\u003eEthics approval and consent to participate\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eApproval of the research protocol: This study was reviewed and approved by the Medical Ethics Committee of Chongqing Medical University. The Ethics number: K2023-019. All methods were carried out in accordance with the Declaration of Helsinki.\u0026nbsp;We state that informed consent was obtained from all subjects and/or their legal guardian(s).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eConsent for publication\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAvailability of data and materials\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eCompeting interests\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eFunding\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAuthors\u0026rsquo; Contributions\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFY contributed to the conception and design of the study. KQ provided the study materials and patients. DC and CT collected and assembled data. FY wrote the first draft of the manuscript. SW、FH and YL contributed to the manuscript modification. All authors contributed to the manuscript revision and read and approved the submitted version.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAcknowledgments\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors are grateful to all their colleagues who helped prepare this article. We thank Yi Xiao for his diligence in data entry.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eShiels, M.S and E.A Engels, Evolving epidemiology of HIV-associated malignancies Current Opinion in HIV and AIDS, 2017 12(1): p 6-11.\u003c/li\u003e\n\u003cli\u003eNasti, G., et al., Impact of highly active antiretroviral therapy on the presenting features and outcome of patients with acquired immunodeficiency syndrome-related Kaposi sarcoma Cancer, 2003 98(11): p 2440-2446.\u003c/li\u003e\n\u003cli\u003eBerretta, M., et al., Therapeutic approaches to AIDS-related malignancies Oncogene, 2003 22(42): p 6646-6659.\u003c/li\u003e\n\u003cli\u003eMartellotta, F., et al., AIDS-related Kaposi\u0026apos;s sarcoma: state of the art and therapeutic strategies Curr HIV Res, 2009 7(6): p 634-8.\u003c/li\u003e\n\u003cli\u003eSimard, E.P and E.A Engels, Cancer as a cause of death among people with AIDS in the United States Clin Infect Dis, 2010 51(8): p 957-62.\u003c/li\u003e\n\u003cli\u003eShiels, M.S., et al., A Meta-Analysis of the Incidence of Non-AIDS Cancers in HIV-Infected Individuals JAIDS Journal of Acquired Immune Deficiency Syndromes, 2009 52(5): p 611-622.\u003c/li\u003e\n\u003cli\u003eKan, M., et al., Colorectal and anal cancer in HIV/AIDS patients: a comprehensive review Expert Rev Anticancer Ther, 2014 14(4): p 395-405.\u003c/li\u003e\n\u003cli\u003eSung, H., et al., Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries CA: A Cancer Journal for Clinicians, 2021 71(3): p 209-249.\u003c/li\u003e\n\u003cli\u003eBini, E.J., B Green and M.A Poles, Screening colonoscopy for the detection of neoplastic lesions in asymptomatic HIV-infected subjects Gut, 2009 58(8): p 1129-1134.\u003c/li\u003e\n\u003cli\u003eReiffel, J.A., Propensity Score Matching: The \u0026lsquo;Devil is in the Details\u0026rsquo; Where More May Be Hidden than You Know The American Journal of Medicine, 2020 133(2): p 178-181.\u003c/li\u003e\n\u003cli\u003eAustin, P.C., Balance diagnostics for comparing the distribution of baseline covariates between treatment groups in propensity-score matched samples Statistics in Medicine, 2009 28(25): p 3083-3107.\u003c/li\u003e\n\u003cli\u003eMatsuoka, Y., et al., Highly Effective Extraction of Carcinoembryonic Antigen with Phosphatidylinositol-Specific Phospholipase C Tumor biology, 1991 12(2): p 91-98.\u003c/li\u003e\n\u003cli\u003eKinugasa, T., et al., Non-proteolytic release of carcinoembryonic antigen from normal human colonic epithelial cells cultured in collagen gel Int J Cancer, 1994 58(1): p 102-7.\u003c/li\u003e\n\u003cli\u003eVirji, M., CEA and innate immunity Trends Microbiol, 2001 9(6): p 258-9.\u003c/li\u003e\n\u003cli\u003eHammarstrom, S., The carcinoembryonic antigen (CEA) family: structures, suggested functions and expression in normal and malignant tissues Semin Cancer Biol, 1999 9(2): p 67-81.\u003c/li\u003e\n\u003cli\u003eReinhold, J., et al., Colorectal Cancer Screening in HIV-Infected Patients 50 Years of Age and Older: Missed Opportunities for Prevention The American Journal of Gastroenterology, 2005 100(8): p 1805-1812.\u003c/li\u003e\n\u003cli\u003eDal Maso, L., D Serraino and S Franceschi, Epidemiology of AIDS-related tumours in developed and developing countries Eur J Cancer, 2001 37(10): p 1188-201.\u003c/li\u003e\n\u003cli\u003eFaqih, A., et al., Colorectal Neoplasia among Patients with and without Human Immunodeficiency Virus Cancer Epidemiology, Biomarkers \u0026amp; Prevention, 2020 29(8): p 1689-1691.\u003c/li\u003e\n\u003cli\u003eCoghill, A.E., et al., Risk of Breast, Prostate, and Colorectal Cancer Diagnoses Among HIV-Infected Individuals in the United States J Natl Cancer Inst, 2018 110(9): p 959-966.\u003c/li\u003e\n\u003cli\u003eSUNEJA, G., et al Cancer Treatment Disparities in HIV-Infected Individuals in the United States 2014 Alexandria, VA: American Society of Clinical Oncology.\u003c/li\u003e\n\u003cli\u003eSuneja, G., et al., Cancer Treatment in Patients With HIV Infection and Non-AIDS-Defining Cancers: A Survey of US Oncologists J Oncol Pract, 2015 11(3): p e380-7.\u003c/li\u003e\n\u003cli\u003eBerretta, M., et al., Clinical Presentation and Outcome of Colorectal Cancer in HIV-Positive Patients: A Clinical Case-Control Study Onkologie, 2009 32(6): p 319-324.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"colorectal cancer, HIV, propensity score matching, oncological features, surgical safety, prognosis","lastPublishedDoi":"10.21203/rs.3.rs-2556602/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-2556602/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe purpose of this study was to compare the differences in oncological features, surgical safety and prognosis between HIV positive CRC patients and HIV negative CRC patients with the same T stage and the same tumor site.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePatients and Methods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe collected a total of 24 patients with HIV infection combined with CRC who underwent radical resection of CRC. With the method of random stratified sampling, A total of 363 postoperative patients with colorectal adenocarcinoma without HIV infection were collected. After propensity score matching(PSM), we got 72 patients (HIV\u003csup\u003e+\u003c/sup\u003e∶HIV\u003csup\u003e-\u003c/sup\u003e=24∶48). The differences of perioperative serological indexes, surgical safety, oncological features and long-term prognosis were compared.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOf 363 HIV negative CRC patients, 48 HIV negative patients were matched with 24 HIV positive patients. Compared with HIV negative patients, less HIV positive patients received chemotherapy, HIV\u003csup\u003e+\u003c/sup\u003e patients had fewer preoperative leukocytes, fewer postoperative leukocytes, fewer preoperative lymphocytes, lower CEA, more intraoperative bleeding, more metastatic lymph nodes, higher N stage, higher TNM stage, shorter overall survival and shorter progression free survival.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCompared with HIV negative CRC patients, HIV positive patients with the same T stage and the same tumor site have more metastatic lymph nodes and worse long-term survival after surgery, but the risk of surgery will not increase.\u003c/p\u003e","manuscriptTitle":"Oncological Features and Prognosis of HIV-positive Colorectal Cancer: An analysis using propensity score matching","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-02-16 20:06:16","doi":"10.21203/rs.3.rs-2556602/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"ff1f04d3-23bf-4650-83d1-8e7d7e693244","owner":[],"postedDate":"February 16th, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2023-06-27T08:14:25+00:00","versionOfRecord":[],"versionCreatedAt":"2023-02-16 20:06:16","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-2556602","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-2556602","identity":"rs-2556602","version":["v1"]},"buildId":"-HB7Z8yhvgn0wM9Nzuekk","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}