Retrospective comparative analysis of clinical, laboratory, and imaging features of Pneumocystis jirovecii pneumonia among HIV-infected individuals and patients with cancer

Retrospective comparative analysis of clinical, laboratory, and imaging features of Pneumocystis jirovecii pneumonia among HIV-infected individuals and patients with cancer | 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 Retrospective comparative analysis of clinical, laboratory, and imaging features of Pneumocystis jirovecii pneumonia among HIV-infected individuals and patients with cancer Jianhua Fang, Zhenhui Pan, Jiayue Li, Jingyi Huang, Shouhua Zhang, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3065296/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 Objective: To retrospectively compare the clinical, laboratory, and imaging features of Pneumocystis jirovecii pneumonia among HIV-infected individuals and patients with cancer in order to provide evidence for early detection, diagnosis, and treatment. Methods: Fourty-three patients with PJP diagnosed at the First Affiliated Hospital of Nanchang University from January 2017 to August 2022 were enrolled. Pneumocystis jirovecii pneumonia patients were divided into an HIV-infected group and a cancer group.A retrospective comparative analysis of clinical, laboratory, and imaging features was conducted in both groups.Statistical analysis using SPSS version 26.0 was performed. Results: Clinical indicators such as total protein, globulin,the ratio of albumin to globulin(AGR),γ-glutamyl transpeptidase(γ-GGT),alkaline phosphatase, triglyceride, total cholesterol,and blood glucose were statistically different in PJP-HIV and PJP-cancer.PJP-HIV patients mainly presented with upper respiratory symptoms, generally with fever as the first symptom,whereas the majority of PJP-cancer patients had systemic symptoms.Furthermore,PJP-HIV patients demonstrated early clinical and radiologic characteristics of lung diseases,while PJP-cancer patients had a later appearance.PJP-cancer patients had a longer length of hospital stay(58.8%,P=0.187),a higher rate of mechanical ventilation(11.1%,P＜0.05),and a higher probability of ICU admission（77.8%,P＜0.05）compared with PJP-HIVpatients. Conclusions: PJP-HIV patients presented with non-systemic symptoms and early abnormal lung imaging features, while PJP-cancer patients presented with systemic symptoms and late abnormal lung imaging features. Laboratory data for both groups, however, show significant statistical significance. Pneumocystis jirovecii pneumonia HIV Cancer Clinical characteristics Imaging features Figures Figure 1 Introduction Pneumocystis jiroveci pneumonia is the most common opportunistic infection in HIV patients, and it is also an important but sporadic opportunistic lung infection in immunocompromised HIV seronegative population(Hakamifard et al.,2022).In previous studies,risk factors for the high incidence of Pneumocystis jiroveci pneumonia included severe malnutrition,primary immunodeficiency,hematological malignancies,and solid organ or bone marrow transplantation(Nasr et al.,2022).Recently, patients with cancer, especially those receiving high-dose corticosteroid therapy or chemotherapy, have been identified as a group of concern for a recent increased risk of Pneumocystis jiroveci pneumonia(Schoovaerts et al.,2017).But the clinical data differentiation of PJP-HIV and PJP-cancer for diagnostic features is still overlooked.Therefore, herein we retrospectively compare the clinical, laboratory, and imaging features of PJP-HIV and PJP-cancer in order to provide evidence for early detection, diagnosis, and treatment. Methods Study design and patient selection Fourty-three patients with Pneumocystis jirovecii pneumonia diagnosed at the First Affiliated Hospital of Nanchang University between January 2017 and August 2022 were enrolled. Pneumocystis jirovecii pneumonia patients were divided into an HIV-infected group and a cancer group.A retrospective comparative analysis of clinical, laboratory, and imaging features was conducted in both groups.This study was approved by the Medical Ethics Committee of the First Affiliated Hospital of Nanchang University. Clinical data Demographics and general, respiratory, and cardiovascular symptoms were recorded. Laboratory results were taken, including alanine aminotransferase,mean corpuscular volume, red blood cell distribution width, platelet specific volume, total protein, globulin,AGR,γ-GGT,alkaline phosphatase,blood glucose,triglyceride,total cholesterol,lactate dehydrogenase,and C-reactive protein.In addition,chest CT(computerized tomography) data was included. Statistical analysis Normal distribution was compared using the t-test for two-group analysis. However, non-normal distribution comparisons were performed using non-parametric tests for two-group analysis. Categorical variables were expressed as counts and percentages, and the chi-square test or Fisher’s exact test was used to test for significance between the two groups. Values of P less than 0.05 (two-sided) were considered to define statistical significant difference. IBM SPSS Statistics version 26.0 was used for all statistical analyses. Results Clinical and demographic characteristics of the patients Thirteeen of forty-three patients diagnosed with Pneumocystis jirovecii pneumonia had lung cancer (seven cases of small cell lung cancer, 1 case of lung adenocarcinoma, and five cases of squamous cell lung carcinoma). There were sixteen cases of HIV, nine cases of hematological malignancies (two cases of acute leukemia and seven cases of diffuse large B-cell lymphoma), and five cases of other cancers (a case of liver cancer, two cases of gastric cancer,a case of thymic cancer, and a case of colon cancer). Among them, a larger proportion (thirteen out of sixteen cases, or 81.25%) of PJP patients in the HIV-infected group had fever than those in the cancer group. Furthermore, HIV-infected patients were younger, with a higher proportion of male patients (P<0.05). The common clinical symptoms of PJP patients include cough, dyspnea and low-grade fever. It is worth noting that compared with PJP-HIV patients,PJP-cancer patients usually developed rapidly, low fungal burden and more severe clinical manifestations, such as cough and sputum (62.5% vs 63%), chest tightness (37.5% vs 55.6%), and asthma (18.8% vs 40.7%). The clinical features differed between the two groups: fever (12,81.25%), cough (10,62.5%), and dyspnea (3,18.8%) were more common in HIV-infected patients, while in patients with cancer, chest tightness (15,55.6%), asthma (11,40.7%), cough (17,63%),expectoration,and other pulmonary symptoms were more common. However,the differing clinical features were more like the typical symptoms of Pneumocystis jirovecii pneumonia. The results are shown in Table 1. Comparison of the chest CT findings Among the 27 patients in the cancer group, twenty-two patients had bilateral lung lesions (88.89%),nineteen patients had mediastinal lymph node enlargement (70.00%), and nine patients had pleural effusion (33.00%). Among the 16 HIV-infected patients,thirteen patients had bilateral lung lesions (81.25%),twelve patients had mediastinal lymph node enlargement (75.00%), and a patient had pleural effusion (8.33%)（Common findings of lung and mediastinal ct in both groups were shown in the figure1）.Among them, eight cases of PJP -HIVpatients had ground glass opacity changes in lung CT images, while 23 cases of cancer patients had severe infection in lung CT images, mostly cords, reticulars, nodular shadows, and other changes.In addition, twenty-two patients in the cancer group had a bilateral and centrilobular distribution of shadows, whereas the majority of patients infected with HIV had bilateral involvement with frequent onset in the peripheral lung area; the results are shown in Table 2. The findings support the notion that PJP should be suspected in HIV-infected or cancer patients with fever, cough, and dyspnea, especially if chest imaging demonstrates bilateral ground-glass opacity. Comparison of blood biochemical test results Univariate statistical analyses were performed for multiple variables in the HIV- infected and cancer groups. Using p < 0.05 as the criterion, we found significant differences in 13 variables between the two groups (Table 3). There were significant differences in alanine aminotransferase, age, mean corpuscular volume, red blood cell distribution width, platelet specific volume, total protein, globulin, AGR , γ-GGT, alkaline phosphatase, blood glucose, triglyceride and total cholesterol between the two groups (p < 0.05). It is suggested that the above indicators had different effects on the occurrence of PJP in the two groups. Discussion Pneumocystis jirovecii pneumonia (PJP), previously known as Pneumocystis carinii pneumonia,is an interstitial plasma cell pneumonia brought on by the opportunistic pulmonary fungus that affects an immunocompromised population such as the HIV-infected, cancer chemotherapeutic recipients, immune agent therapy recipients, organ transplantation recipients, and those with congenital immunodeficiency disorders (Tasaka et al.,2020). Pneumocystis jirovecii pneumonia (PJP) had a significant impact on patient morbidity and mortality.Among them, the prognosis of PJP-non-HIV patients is poor and the sensitivity of diagnostic tests is low(Braga et al.,2019).Recently, cancer patients, especially those receiving high-dose corticosteroid therapy or chemotherapy, had emerged as an increased risk factor for pneumocystis jirovecii pneumonia(Schoovaerts et al.,2017). Therefore, herein we retrospectively compare the clinical, laboratory, and imaging features of Pneumocystis jirovecii pneumonia in patients with HIV infection and cancer in order to provide evidence for early detection, diagnosis, and treatment. In our study, the sample size of the retrospective comparison was larger than that of previous research on the clinical, laboratory, and imaging features of PJP among patients with HIV infection and cancer. Clinical symptoms such as dyspnea, cough, and fever were present in varying degrees in more than half of the PJP patients with HIV infection and cancer, which is consistent with previously published studies(Santamauro et al.,1997). In the context of the chest CT, both the HIV-infected group and the cancer group exhibited typical interstitial lung alterations. These alterations compromised the following: 1: lung lesions in the HIV-infected group were bilateral, while those in the cancer group were unilateral; 2: all lesions showed ground glass opacity, though the majority in the cancer group were heterogeneous; 3: the severity of lesions was lower in the HIV-infected group compared to the cancer group; 4: mediastinal lymphadenopathy and pleural effusion were common complications among the cancer group. It is important to note that pleural effusions are extremely difficult to detect in the early and latent stages of HIV when the virus is dormant.This study shows that just one of the HIV patients had pleural effusion, which suggests that HIV infections occurred during the early and middle stages of the disease progression. Furthermore, the severity of lung damage in the PJP-HIV and PJP-cancer patient groups suggests that PJP-cancer is more ruinous to the lung and more likely to produce systemic disorders(Schoovaerts et al.,2017). Lastly, when comparing PJP-HIVgroup with PJP-cancer group, our laboratory analysis findings revealed that both groups' lymphocyte-white blood cell count ratios were not statistically different from normal.Patients with cancer and HIV who were admitted to the hospital might not have had agranulocytosis because they were treated early. Lactate dehydrogenase levels were higher in both PJP-HIV and PJP-cancer groups, but PJP-cancer group had a higher increase, indicating that PJP-cancer patients have a more severe disease and a worse prognosis (Wang et al.,2021).C-reactive protein was significantly higher in the PJP-cancer group than in the PJP-HIV group, suggesting the PJP-cancer group had stronger immunosuppression and a greater infection risk.C-reactive protein levels rose in both groups, but the PJP-cancer patients had a more dramatic rise than the PJP-HIV patients did. There are still manyenigmas surrounding the pathophysiological mechanism of the CRP rise in cancer patients undergoing chemotherapy. It is also considered that cancer patients are prone to infection and high CRP during chemotherapy, which may be related to systemic inflammation and immunosuppression, immune senescence, complications, malnutrition, smoking, and anatomical obstruction(Rapoport et al.,2021).The existing literature, however, holds that acute-phase responses generate a rapid increase in CRP (Cooley et al.,2014).We believe that this viewpoint is the primary cause of the PJP-cancer group's increased C-reactive protein levels. Total protein, globulin, and AGR assist the body's inflammatory response, which boosts resistance and prevents infection.Thus, all three of these are crucial immunological building blocks. However, among them, immunoglobulin, also known as globulin, is clinically significant because decreased globulin levels predict disorders of the immune system (Wang et al.,2021). Many studies have shown that the total protein and globulin levels are relatively low in cancer patients, while the AGR is relatively high, which may be a predictor of early immune dysfunction in cancer patients(Suh et al.,2014). It is also considered that the long-term chemotherapy of cancer patients leads to obvious bone marrow suppression, and cannot produce enough white blood cells and neutrophils, thereby suppressing the immune system. In our study,the cancer group's age of onset ranged from 55 to 70 years old. The difference in age between the HIV-infected and cancer groups was statistically significant P<0.05). The risk of PJP under the influence of chemotherapy increases with age, which may be attributed to several processes such as aging and the immune system’s response(Bueno et al.,2014). Pneumocystis jirovecii pneumonia and that serum γ -GGT is a sensitive and early indicator of oxidative stress (Hanigan et al.,2014). Another study has reported that lung tissue has lower γ-GGT than liver or renal tissue (Mistry et al.,2010). In our analysis, however, the cancer group had a considerably higher GGT than the HIV-infected group. The precise mechanism that explains the volatility needs to be explored in future research. ALP's physical and chemical characteristics vary from organ to organ, and its precise physiological role is still unknown. There is evidence from clinical studies that ALP can be found in a variety of tissues (liver, bone, small intestine, and placenta) for extended periods of time. Studies have reported that the alkaline phosphatase level rises dramatically once cancer has spread to the bones (Du et al.,2014). The current study found that the ALP level in the blood of PJP-cancer patients was significantly higher than that of PJP-HIV patients. This may be because the cancer itself is causing the ALP level to rise. Our study still has several limitations. First, the retrospective design with a single center. Second, the sample size of our study was relatively small and uneven. Therefore, we cannot determine whether our data are phenotypically similar in the case of larger samples. Despite these limitations, the present study’s strength is that it provides a preliminary basis for future clinical studies with large samples. Conclusions These results not only indicated that patients with PJP-HIV differ from those with PJP-cancer in terms of clinical, laboratory, and imaging features, but also that the effect of treatment in these two groups is not clear. Therefore, further studies are needed to understand how to avoid PJP in HIV patients with cancer at an early stage. Declarations Ethical approval and consent to participate This study was reviewed and approved by the Ethics Committee of the First Affiliated Hospital of Nanchang University(NO:(2023)CDYFYYLK(01-025)). All methods were performed in accordance with the relevant guidelines and regulations. Informed consent was obtained from all subjects for this study. Consent to publish NA. Conflict of interest disclosure The authors declare that they have no competing interest. Availability of data and materials The data that support the findings of this study are available from the corresponding author upon reasonable request. Acknowledgements Not applicable. Authors' contributions Study design:Jianhua Fang,Tianxin Xiang;Data collection:Zhenhui Pan,Jiayue Li,Jingyi Huang;Data analysis:Jianhua Fang,Zhenhui Pan;Writing:Shouhua Zhang,Tianxin Xiang,Jianhua Fang. Funding Funding sources for this study were offered by 2020 Clinical Research Training Program of Nanchang University (YFYLCYJPY202001-3), the National Natural Science Foundation of China (82000601), the Technology Program of Health Commission of Jiangxi Province (202130167), Zhong Nanshan Foundation of Guangdong Province(ZNSXS-20220067). References Hakamifard, A., Mardani, M., Nasiri, M. J., & Gholipur-Shahraki, T. (2022). Bendamustine and pneumocystis pneumonia: A systematic review. Health science reports, 5(3), e610. https://doi.org/10.1002/hsr2.610 Nasr, M., Mohammad, A., Hor, M., Baradeiya, A. M., & Qasim, H. (2022). Exploring the Differences in Pneumocystis Pneumonia Infection Between HIV and Non-HIV Patients. Cureus, 14(8), e27727. https://doi.org/10.7759/cureus.27727 Schoovaerts, K., Dirix, L., Rutten, A., Van Schaeren, J., Van Herendael, B., Van Grieken, S., & Heytens, L. (2017). Pneumocystis jiroveci pneumonia (PJP) in non-HIV immunocompromised individuals. Acta clinica Belgica , 72 (6),413–416. https://doi.org/10.1080/17843286.2017.1305136 Tasaka S. (2020). Recent Advances in the Diagnosis and Management of Pneumocystis Pneumonia. Tuberculosis and respiratory diseases, 83(2), 132–140. https://doi.org/10.4046/trd.2020.0015 Braga, B. P., Prieto-González, S., & Hernández-Rodríguez, J. (2019). Pneumocystis jirovecii pneumonia prophylaxis in immunocompromised patients with systemic autoimmune diseases.Medicina clinica, 152(12), 502–507. https://doi.org/10.1016/j.medcli.2019.01.010 Santamauro, J. T., & Stover, D. E. (1997). Pneumocystis jiroveci pneumonia. The Medical clinics of North America, 81(2), 299–318. https://doi.org/10.1016/s0025-7125(05)70519-8 Schoovaerts, K., Dirix, L., Rutten, A., Van Schaeren, J., Van Herendael, B., Van Grieken, S., & Heytens, L. (2017). Pneumocystis jiroveci pneumonia (PJP) in non-HIV immunocompromised individuals. Acta clinica Belgica , 72 (6),413–416. https://doi.org/10.1080/17843286.2017.1305136 Wang, Y., Zhou, X., Saimi, M., Huang, X., Sun, T., Fan, G., & Zhan, Q. (2021). Risk Factors of Mortality From Pneumocystis Pneumonia in Non-HIV Patients: A Meta-Analysis. Frontiers in public health, 9, 680108. https://doi.org/10.3389/fpubh.2021.680108 Rapoport, B. L., Cooksley, T., Johnson, D. B., Anderson, R., & Shannon, V. R. (2021). Treatment of infections in cancer patients: an update from the neutropenia, infection and myelosuppression study group of the Multinational Association for Supportive Care in Cancer (MASCC). Expert review of clinical pharmacology, 14(3), 295–313. https://doi.org/10.1080/17512433.2021.1884067 Cooley, L., Dendle, C., Wolf, J., Teh, B. W., Chen, S. C., Boutlis, C., & Thursky, K. A. (2014). Consensus guidelines for diagnosis, prophylaxis and management of Pneumocystis jirovecii pneumonia in patients with haematological and solid malignancies, 2014. Internal medicine journal, 44(12b), 1350–1363. https://doi.org/10.1111/imj.12599 Wang, H., Zhou, H., Jiang, R., Qian, Z., Wang, F., & Cao, L. (2021). Globulin, the albumin-to-globulin ratio, and fibrinogen perform well in the diagnosis of Periprosthetic joint infection. BMC musculoskeletal disorders, 22(1), 583. https://doi.org/10.1186/s12891-021-04463-7 Suh, B., Park, S., Shin, D. W., Yun, J. M., Keam, B., Yang, H. K., Ahn, E., Lee, H., Park, J. H., & Cho, B. (2014). Low albumin-to-globulin ratio associated with cancer incidence and mortality in generally healthy adults. Annals of oncology : official journal of the European Society for Medical Oncology, 25(11), 2260–2266. https://doi.org/10.1093/annonc/mdu274 Bueno, V., Sant'Anna, O. A., & Lord, J. M. (2014). Ageing and myeloid-derived suppressor cells: possible involvement in immunosenescence and age-related disease. Age (Dordrecht, Netherlands), 36(6), 9729. https://doi.org/10.1007/s11357-014-9729-x Hanigan M. H. (2014). Gamma-glutamyl transpeptidase: redox regulation and drug resistance. Advances in cancer research, 122, 103–141. https://doi.org/10.1016/B978-0-12-420117-0.00003-7 Mistry, D., & Stockley, R. A. (2010). Gamma-glutamyl transferase: the silent partner?. COPD, 7(4), 285–290. https://doi.org/10.3109/15412555.2010.496819 Du, W. X., Duan, S. F., Chen, J. J., Huang, J. F., Yin, L. M., & Tong, P. J. (2014). Serum bone-specific alkaline phosphatase as a biomarker for osseous metastases in patients with malignant carcinomas: a systematic review and meta-analysis. Journal of cancer research and therapeutics, 10 Suppl, C140–C143. https://doi.org/10.4103/0973-1482.145842 Tables Table 1.Clinical characteristics of patients with PJP-HIV and PJP-cancer HIV（n=16） Cancer（n=27） P-Value Age（years） <0.001 Age group：number <30 3（18.8%） 1（3.7%） 30-55 7（43.8%） 6（22.2%） 55-60 3（18.8%） 4（14.8%） 60-70 2（12.5%） 9（33.3%） 70-80 1（6.25%） 7（25.9%） Symptom：number Fever 12（81.25%） 17（62.96%） 0.212 Cough expectoration 10（62.5%） 17（63.0%） 0.976 Chest distress 6（37.5%） 15（55.6%） 0.252 Asthma 3（18.8%） 11（40.7%） 0.137 Dyspnea 3（18.8%） 2（7.4%） 0.262 Use of ventilator 0(0%) 3(11.1%) <0.05 ICU Admission 5（31.3%） 21（77.8%） <0.05 Length of stay 13.3(41.2%) 19.0(58.8%) 0.187 Table 2.Comparison of chest imaging findings Group mediastinal lymphadenopathy Pleural cavity Yes No Yes No PJP-HIV 7 8 1 14 PJP-cancer 19 8 9 18 Group GGO Focal attenuation Maximum lesion range Bilateral Unilateral Ground-geass mixture ≦3.0cm >3.0cm PJP-HIV 13 2 8 7 13 2 PJP-cancer 24 3 3 24 18 9 GGO represents ground glass opacity. Table3.Variables with significant differences between HIV and Cancer groups Variables HIV group (n = 16) Cancer group (n = 27) p-Value AUROC Males/Females 14/2 21/6 - - Age (years) 48.00±3.62 60.11±2.76 0.011 0.753 Complete Blood Count: WBC (×10^9/L) 5.77±2.02 6.36（3.41,11.64） 0.482 0.565 RBC (×10^12/L) 3.77±0.64 3.77±0.64 0.528 0.582 Hb (g/L) 112.44±15.99 112.44±15.99 0.448 0.531 HCT (L/L) 0.34±0.46 0.34±0.05 0.361 0.507 MCV (fL) 90.08±5.09 90.08±5.09 0.019 0.716 MCH (pg) 30.03±1.88 30.6（29.4,31.7） 0.131 0.639 MCHC (g/L) 331.5（329.25,335.25） 333.25±7.11 0.07 0.667 RDW 13.3（12.4,14.45） 15.9（13.7,17.8） 0.001 0.81 PLT (×10^9/L) 239±105.57 175（144，229） 0.056 0.676 MPV (fL) 10.51±1.85 10.51±1.85 0.241 0.527 PCT (%) 0.24±0.84 0.17（0.14,0.22） 0.04 0.689 PDW (fl) 13.91±3.34 16.1（12.2,16.5） 0.155 0.631 LYMPH# (×10^9/L) 0.81±0.34 0.81±0.34 0.151 0.542 MONO# (×10^9/L) 0.39±0.21 0.38(0.17,0.53) 0.95 0.506 NEUT# (×10^9/L) 4.42±1.84 5.41(2.38,9.54) 0.421 0.574 EOS# (×10^9/L) 0.13±0.92 0.08(0.01,0.16) 0.246 0.606 BASO# (×10^9/L) 0.02±0.01 0.01(0.01,0.02) 0.205 0.608 CRP 42.08±39.47 53.11(19.32,108.8) 0.34 0.588 ALT (U/L) 13.80(11.50,26.00) 22.00(16.00,36.00) 0.018 0.724 AST (U/L) 31.45(22.50,40.93) 35.00(23.00,49.00) 0.466 0.744 T-BIL (umol/L) 7.40(6.33,8.78) 9.20(6.20,17.20) 0.213 0.596 D-BIL (umol/L) 2.25(1.58,3.05) 2.50(1.60,6.00) 0.237 0.580 TP (g/L) 69.83±2.21 62.05±1.42 0.003 0.657 ALB (g/L) 31.60±1.30 33.44±0.98 0.261 0.580 GLB (g/L) 38.23±1.76 28.61±1.32 <0.001 0.788 A/G 0.85(0.65,0.95) 1.17(0.97,1.53) 0.001 0.769 γ-GGT (U/L) 23.00(19.25,36.75) 48.00(24.00,200.10) 0.023 0.641 ALP (U/L) 79.5(61.20,101.375) 104.80(78.10,219.50) 0.012 0.827 Cr (umol/L) 65.20(54.60,81.40) 63.80(44.90,86.30) 0.498 0.622 UREA (mmol/L) 4.50(3.29,5.60) 5.40(3.70,7.92) 0.163 0.721 UA (umol/L) 293.94±26.93 272.24±18.15 0.493 0.526 TC (mmol/L) 3.73±0.23 4.74±0.26 0.009 0.760 TG (mmol/L) 1.04(0.80,1.46) 1.7(1.16,2.79) 0.016 0.731 CK (U/L) 37.20(23.25, 2.90) 42.10(32.00, 64.00) 0.291 0.597 CK-MB (U/L) 15.40(12.85, 2.08) 17.80(12.10, 23.30) 0.606 0.547 LDH (U/L) 355.94±123.46 416.36±183.92 0.112 0.593 D-Dimer (mg/L) 1.01 (0.81, 1.16) 0.63 (0.32, 6.13) 0.716 0.534 PT (s) 11.90(11.20,12.53) 11.90(10.70, 12.90) 0.772 0.527 PTA (%) 102.77±12.92 99.60±23.07 0.081 0.554 INR 1.01 (0.93, 1.04) 1.03 (0.95, 1.13) 0.352 0.586 APTT (s) 31.86±6.58 27.69±4.12 0.138 0.694 FIB (g/L) 4.97±1.53 4.45±1.66 0.869 0.600 TT (s) 16.85(15.83, 7.77) 15.80(13.60, 16.90) 0.100 0.652 Additional Declarations No competing interests reported. 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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-3065296","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":223105005,"identity":"b3fce4e8-140e-47b1-88bf-b661a3d3d219","order_by":0,"name":"Jianhua Fang","email":"","orcid":"","institution":"the First Affiliated Hospital of Nanchang University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Jianhua","middleName":"","lastName":"Fang","suffix":""},{"id":223105006,"identity":"dda85949-e80c-48ea-b27b-58b51230a86a","order_by":1,"name":"Zhenhui Pan","email":"","orcid":"","institution":"Nanchang University，Nanchang","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Zhenhui","middleName":"","lastName":"Pan","suffix":""},{"id":223105007,"identity":"2dea3722-4696-4080-96bb-efe0e040947e","order_by":2,"name":"Jiayue Li","email":"","orcid":"","institution":"Nanchang University，Nanchang","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Jiayue","middleName":"","lastName":"Li","suffix":""},{"id":223105008,"identity":"ce4b8d18-3e95-4d91-92e7-d3e578041145","order_by":3,"name":"Jingyi Huang","email":"","orcid":"","institution":"Nanchang University，Nanchang","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Jingyi","middleName":"","lastName":"Huang","suffix":""},{"id":223105009,"identity":"2e52cf48-a1bc-4834-bc15-664978b90f78","order_by":4,"name":"Shouhua Zhang","email":"","orcid":"","institution":"Nanchang University，Nanchang","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Shouhua","middleName":"","lastName":"Zhang","suffix":""},{"id":223105010,"identity":"4c428e78-8a51-4050-8866-7ad7d145fd9c","order_by":5,"name":"Tianxin Xiang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA0UlEQVRIiWNgGAWjYJCCAxAq+cCBDz+IUM6D0JKWeHBmD5FaoCDH+DAHGxFa7CVyDA/83FEbzc+e8+Ew0AR5frEDBGzhOZZwsPfM8dyZPW83HC6wYDCcOTuBgBb25gMHeNuO5W64kbvh8AwehgSD24S0MDM2HPwL1LL/Rs6DwzxsxGgB2nKYt60md4NEDgORWs4cSzgs23Ygd8aZZwbAQJYg7Bf2GTnGH9+21eX2tyc//vDhh408vzQBLVBwGMaQIEo5CNQRrXIUjIJRMApGIAAAIpZM9OqLalkAAAAASUVORK5CYII=","orcid":"","institution":"the First Affiliated Hospital of Nanchang University","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Tianxin","middleName":"","lastName":"Xiang","suffix":""}],"badges":[],"createdAt":"2023-06-15 02:29:13","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3065296/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3065296/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":41098111,"identity":"2efb736b-4e47-4b0d-b564-147c3befa7bc","added_by":"auto","created_at":"2023-08-04 23:39:09","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":63188,"visible":true,"origin":"","legend":"\u003cp\u003eThe common manifestations of lungs and mediastinum in computed tomography among HIV group and cancer group. The injuries shown by the green arrow is a hilar mass in the right lung with a spiculate edge (a). The injuries shown by the orange arrow is a mediastinal lymphadenopathy (b). The injuries showns by red arrows are patchy ground glass opacities (c). The injuries shown by the green arrow is the right pleural effusion (d).\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-3065296/v1/143ec390b5aa319009bc5196.jpg"},{"id":42152358,"identity":"970bf3ea-b060-424f-bc1f-ce25be989615","added_by":"auto","created_at":"2023-08-25 17:37:19","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":311888,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3065296/v1/10eb4b3a-215b-4421-9fec-ca914fa1148e.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Retrospective comparative analysis of clinical, laboratory, and imaging features of Pneumocystis jirovecii pneumonia among HIV-infected individuals and patients with cancer","fulltext":[{"header":"Introduction","content":"\u003cp\u003e \u003cem\u003ePneumocystis\u003c/em\u003e jiroveci pneumonia is the most common opportunistic infection in HIV patients, and it is also an important but sporadic opportunistic lung infection in immunocompromised HIV seronegative population(Hakamifard et al.,2022).In previous studies,risk factors for the high incidence of Pneumocystis jiroveci pneumonia included severe malnutrition,primary immunodeficiency,hematological malignancies,and solid organ or bone marrow transplantation(Nasr et al.,2022).Recently, patients with cancer, especially those receiving high-dose corticosteroid therapy or chemotherapy, have been identified as a group of concern for a recent increased risk of \u003cem\u003ePneumocystis\u003c/em\u003e jiroveci pneumonia(Schoovaerts et al.,2017).But the clinical data differentiation of PJP-HIV and PJP-cancer for diagnostic features is still overlooked.Therefore, herein we retrospectively compare the clinical, laboratory, and imaging features of PJP-HIV and PJP-cancer in order to provide evidence for early detection, diagnosis, and treatment.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eStudy design and patient selection\u003c/p\u003e \u003cp\u003eFourty-three patients with \u003cem\u003ePneumocystis\u003c/em\u003e jirovecii pneumonia diagnosed at the First Affiliated Hospital of Nanchang University between January 2017 and August 2022 were enrolled.\u003cem\u003ePneumocystis\u003c/em\u003e jirovecii pneumonia patients were divided into an HIV-infected group and a cancer group.A retrospective comparative analysis of clinical, laboratory, and imaging features was conducted in both groups.This study was approved by the Medical Ethics Committee of the First Affiliated Hospital of Nanchang University.\u003c/p\u003e \u003cp\u003eClinical data\u003c/p\u003e \u003cp\u003eDemographics and general, respiratory, and cardiovascular symptoms were recorded. Laboratory results were taken, including alanine aminotransferase,mean corpuscular volume, red blood cell distribution width, platelet specific volume, total protein, globulin,AGR,γ-GGT,alkaline phosphatase,blood glucose,triglyceride,total cholesterol,lactate dehydrogenase,and C-reactive protein.In addition,chest CT(computerized tomography) data was included.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eNormal distribution was compared using the t-test for two-group analysis. However, non-normal distribution comparisons were performed using non-parametric tests for two-group analysis. Categorical variables were expressed as counts and percentages, and the chi-square test or Fisher\u0026rsquo;s exact test was used to test for significance between the two groups. Values of P less than 0.05 (two-sided) were considered to define statistical significant difference. IBM SPSS Statistics version 26.0 was used for all statistical analyses.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eClinical and demographic characteristics of the patients\u003c/p\u003e\n\u003cp\u003eThirteeen of forty-three patients diagnosed with \u003cem\u003ePneumocystis\u003c/em\u003e jirovecii pneumonia had lung cancer (seven cases of small cell lung cancer, 1 case of lung adenocarcinoma, and five cases of squamous cell lung carcinoma). There were sixteen cases of HIV, nine cases of hematological malignancies (two cases of acute leukemia and seven cases of diffuse large B-cell lymphoma), and five cases of other cancers (a case of liver cancer, two cases of gastric cancer,a case of thymic cancer, and a case of colon cancer). Among them, a larger proportion (thirteen out of sixteen cases, or 81.25%) of PJP patients in the HIV-infected group had fever than those in the cancer group. Furthermore, HIV-infected patients were younger, with a higher proportion of male patients (P\u0026lt;0.05).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe common clinical symptoms of PJP patients include cough, dyspnea and low-grade fever. It is worth noting that compared with PJP-HIV patients,PJP-cancer patients usually developed rapidly, low fungal burden and more severe clinical manifestations, such as cough and sputum (62.5% vs 63%), chest tightness (37.5% vs 55.6%), and asthma (18.8% vs 40.7%).\u003c/p\u003e\n\u003cp\u003eThe clinical features differed between the two groups: fever (12,81.25%), cough (10,62.5%), and\u0026nbsp;dyspnea\u0026nbsp;(3,18.8%) were more common in HIV-infected patients, while in patients with cancer, chest tightness (15,55.6%), asthma (11,40.7%), cough (17,63%),expectoration,and other pulmonary symptoms were more common. However,the differing clinical features were more like the typical symptoms of \u003cem\u003ePneumocystis\u0026nbsp;\u003c/em\u003ejirovecii pneumonia. The results are shown in Table 1.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eComparison of the chest CT findings\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAmong the 27 patients in the cancer group, twenty-two patients had bilateral lung lesions (88.89%),nineteen patients had mediastinal lymph node enlargement (70.00%), and nine patients had pleural effusion (33.00%). Among the 16 HIV-infected patients,thirteen patients had bilateral lung lesions (81.25%),twelve patients had mediastinal lymph node enlargement (75.00%), and a patient had pleural effusion (8.33%)（Common findings of lung and mediastinal ct in both groups were shown in the figure1）.Among them, eight cases of PJP -HIVpatients had ground glass opacity changes in lung CT images, while 23 cases of cancer patients had severe infection in lung CT images, mostly cords, reticulars, nodular shadows, and other changes.In addition, twenty-two patients in the cancer group had a bilateral and centrilobular distribution of shadows, whereas the majority of patients infected with HIV had bilateral involvement with frequent onset in the peripheral lung area; the results are shown in Table 2. The findings support the notion that PJP should be suspected in HIV-infected or cancer patients with fever, cough, and dyspnea, especially if chest imaging demonstrates bilateral ground-glass opacity.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eComparison of blood biochemical test results\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eUnivariate statistical analyses were performed for multiple variables in the HIV- infected and cancer groups. Using p \u0026lt; 0.05 as the criterion, we found significant differences in 13 variables between the two groups (Table 3). There were significant differences in alanine aminotransferase, age, mean corpuscular volume, red blood cell distribution width, platelet specific volume, total protein, globulin, AGR , \u0026gamma;-GGT, alkaline phosphatase, blood glucose, triglyceride and total cholesterol between the two groups (p \u0026lt; 0.05). It is suggested that the above indicators had different effects on the occurrence of PJP in the two groups.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003e \u003cem\u003ePneumocystis\u003c/em\u003e jirovecii pneumonia (PJP), previously known as \u003cem\u003ePneumocystis\u003c/em\u003e carinii pneumonia,is an interstitial plasma cell pneumonia brought on by the opportunistic pulmonary fungus that affects an immunocompromised population such as the HIV-infected, cancer chemotherapeutic recipients, immune agent therapy recipients, organ transplantation recipients, and those with congenital immunodeficiency disorders (Tasaka et al.,2020).\u003c/p\u003e \u003cp\u003e \u003cem\u003ePneumocystis\u003c/em\u003e jirovecii pneumonia (PJP) had a significant impact on patient morbidity and mortality.Among them, the prognosis of PJP-non-HIV patients is poor and the sensitivity of diagnostic tests is low(Braga et al.,2019).Recently, cancer patients, especially those receiving high-dose corticosteroid therapy or chemotherapy, had emerged as an increased risk factor for \u003cem\u003epneumocystis\u003c/em\u003e jirovecii pneumonia(Schoovaerts et al.,2017). Therefore, herein we retrospectively compare the clinical, laboratory, and imaging features of \u003cem\u003ePneumocystis\u003c/em\u003e jirovecii pneumonia in patients with HIV infection and cancer in order to provide evidence for early detection, diagnosis, and treatment. In our study, the sample size of the retrospective comparison was larger than that of previous research on the clinical, laboratory, and imaging features of PJP among patients with HIV infection and cancer. Clinical symptoms such as dyspnea, cough, and fever were present in varying degrees in more than half of the PJP patients with HIV infection and cancer, which is consistent with previously published studies(Santamauro et al.,1997).\u003c/p\u003e \u003cp\u003eIn the context of the chest CT, both the HIV-infected group and the cancer group exhibited typical interstitial lung alterations. These alterations compromised the following: 1: lung lesions in the HIV-infected group were bilateral, while those in the cancer group were unilateral; 2: all lesions showed ground glass opacity, though the majority in the cancer group were heterogeneous; 3: the severity of lesions was lower in the HIV-infected group compared to the cancer group; 4: mediastinal lymphadenopathy and pleural effusion were common complications among the cancer group. It is important to note that pleural effusions are extremely difficult to detect in the early and latent stages of HIV when the virus is dormant.This study shows that just one of the HIV patients had pleural effusion, which suggests that HIV infections occurred during the early and middle stages of the disease progression. Furthermore, the severity of lung damage in the PJP-HIV and PJP-cancer patient groups suggests that PJP-cancer is more ruinous to the lung and more likely to produce systemic disorders(Schoovaerts et al.,2017).\u003c/p\u003e \u003cp\u003eLastly, when comparing PJP-HIVgroup with PJP-cancer group, our laboratory analysis findings revealed that both groups' lymphocyte-white blood cell count ratios were not statistically different from normal.Patients with cancer and HIV who were admitted to the hospital might not have had agranulocytosis because they were treated early. Lactate dehydrogenase levels were higher in both PJP-HIV and PJP-cancer groups, but PJP-cancer group had a higher increase, indicating that PJP-cancer patients have a more severe disease and a worse prognosis (Wang et al.,2021).C-reactive protein was significantly higher in the PJP-cancer group than in the PJP-HIV group, suggesting the PJP-cancer group had stronger immunosuppression and a greater infection risk.C-reactive protein levels rose in both groups, but the PJP-cancer patients had a more dramatic rise than the PJP-HIV patients did. There are still manyenigmas surrounding the pathophysiological mechanism of the CRP rise in cancer patients undergoing chemotherapy. It is also considered that cancer patients are prone to infection and high CRP during chemotherapy, which may be related to systemic inflammation and immunosuppression, immune senescence, complications, malnutrition, smoking, and anatomical obstruction(Rapoport et al.,2021).The existing literature, however, holds that acute-phase responses generate a rapid increase in CRP (Cooley et al.,2014).We believe that this viewpoint is the primary cause of the PJP-cancer group's increased C-reactive protein levels.\u003c/p\u003e \u003cp\u003eTotal protein, globulin, and AGR assist the body's inflammatory response, which boosts resistance and prevents infection.Thus, all three of these are crucial immunological building blocks. However, among them, immunoglobulin, also known as globulin, is clinically significant because decreased globulin levels predict disorders of the immune system (Wang et al.,2021). Many studies have shown that the total protein and globulin levels are relatively low in cancer patients, while the AGR is relatively high, which may be a predictor of early immune dysfunction in cancer patients(Suh et al.,2014). It is also considered that the long-term chemotherapy of cancer patients leads to obvious bone marrow suppression, and cannot produce enough white blood cells and neutrophils, thereby suppressing the immune system. In our study,the cancer group's age of onset ranged from 55 to 70 years old. The difference in age between the HIV-infected and cancer groups was statistically significant P\u003c0.05). The risk of PJP under the influence of chemotherapy increases with age, which may be attributed to several processes such as aging and the immune system\u0026rsquo;s response(Bueno et al.,2014).\u003c/p\u003e \u003cp\u003e \u003cem\u003ePneumocystis\u003c/em\u003e jirovecii pneumonia and that serum \u003cb\u003eγ\u003c/b\u003e-GGT is a sensitive and early indicator of oxidative stress (Hanigan et al.,2014). Another study has reported that lung tissue has lower γ-GGT than liver or renal tissue (Mistry et al.,2010). In our analysis, however, the cancer group had a considerably higher GGT than the HIV-infected group. The precise mechanism that explains the volatility needs to be explored in future research.\u003c/p\u003e \u003cp\u003eALP's physical and chemical characteristics vary from organ to organ, and its precise physiological role is still unknown. There is evidence from clinical studies that ALP can be found in a variety of tissues (liver, bone, small intestine, and placenta) for extended periods of time. Studies have reported that the alkaline phosphatase level rises dramatically once cancer has spread to the bones (Du et al.,2014). The current study found that the ALP level in the blood of PJP-cancer patients was significantly higher than that of PJP-HIV patients. This may be because the cancer itself is causing the ALP level to rise.\u003c/p\u003e \u003cp\u003eOur study still has several limitations. First, the retrospective design with a single center. Second, the sample size of our study was relatively small and uneven. Therefore, we cannot determine whether our data are phenotypically similar in the case of larger samples. Despite these limitations, the present study\u0026rsquo;s strength is that it provides a preliminary basis for future clinical studies with large samples.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThese results not only indicated that patients with PJP-HIV differ from those with PJP-cancer in terms of clinical, laboratory, and imaging features, but also that the effect of treatment in these two groups is not clear. Therefore, further studies are needed to understand how to avoid PJP in HIV patients with cancer at an early stage.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was reviewed and approved by the Ethics Committee of the First Affiliated Hospital of Nanchang University(NO:(2023)CDYFYYLK(01-025)). All methods were performed in accordance with the relevant guidelines and regulations. Informed consent was obtained from all subjects for this study.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eConsent to publish\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNA.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest disclosure\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data that support the findings of this study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStudy design:Jianhua Fang,Tianxin Xiang;Data collection:Zhenhui Pan,Jiayue Li,Jingyi Huang;Data analysis:Jianhua Fang,Zhenhui Pan;Writing:Shouhua Zhang,Tianxin Xiang,Jianhua Fang.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFunding sources for this study were offered by 2020 Clinical Research Training Program of Nanchang University (YFYLCYJPY202001-3), the National Natural Science Foundation of China (82000601), the Technology Program of Health Commission of Jiangxi Province (202130167), Zhong Nanshan Foundation of Guangdong Province(ZNSXS-20220067).\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eHakamifard, A., Mardani, M., Nasiri, M. J., \u0026amp; Gholipur-Shahraki, T. (2022). Bendamustine and pneumocystis pneumonia: A systematic review. Health science reports, 5(3), e610. https://doi.org/10.1002/hsr2.610 \u003c/li\u003e\n\u003cli\u003eNasr, M., Mohammad, A., Hor, M., Baradeiya, A. M., \u0026amp; Qasim, H. (2022). Exploring the Differences in Pneumocystis Pneumonia Infection Between HIV and Non-HIV Patients. Cureus, 14(8), e27727. https://doi.org/10.7759/cureus.27727\u003c/li\u003e\n\u003cli\u003eSchoovaerts, K., Dirix, L., Rutten, A., Van Schaeren, J., Van Herendael, B., Van Grieken, S., \u0026amp; Heytens, L. (2017). Pneumocystis jiroveci pneumonia (PJP) in non-HIV immunocompromised individuals. \u003cem\u003eActa clinica Belgica\u003c/em\u003e, \u003cem\u003e72\u003c/em\u003e(6),413\u0026ndash;416. https://doi.org/10.1080/17843286.2017.1305136\u003c/li\u003e\n\u003cli\u003eTasaka S. (2020). Recent Advances in the Diagnosis and Management of Pneumocystis Pneumonia. Tuberculosis and respiratory diseases, 83(2), 132\u0026ndash;140. https://doi.org/10.4046/trd.2020.0015\u003c/li\u003e\n\u003cli\u003eBraga, B. P., Prieto-Gonz\u0026aacute;lez, S., \u0026amp; Hern\u0026aacute;ndez-Rodr\u0026iacute;guez, J. (2019). Pneumocystis jirovecii pneumonia prophylaxis in immunocompromised patients with systemic autoimmune diseases.Medicina clinica, 152(12), 502\u0026ndash;507. https://doi.org/10.1016/j.medcli.2019.01.010\u003c/li\u003e\n\u003cli\u003eSantamauro, J. T., \u0026amp; Stover, D. E. (1997). Pneumocystis jiroveci pneumonia. The Medical clinics of North America, 81(2), 299\u0026ndash;318. https://doi.org/10.1016/s0025-7125(05)70519-8\u003c/li\u003e\n\u003cli\u003eSchoovaerts, K., Dirix, L., Rutten, A., Van Schaeren, J., Van Herendael, B., Van Grieken, S., \u0026amp; Heytens, L. (2017). Pneumocystis jiroveci pneumonia (PJP) in non-HIV immunocompromised individuals. \u003cem\u003eActa clinica Belgica\u003c/em\u003e, \u003cem\u003e72\u003c/em\u003e(6),413\u0026ndash;416. https://doi.org/10.1080/17843286.2017.1305136\u003c/li\u003e\n\u003cli\u003eWang, Y., Zhou, X., Saimi, M., Huang, X., Sun, T., Fan, G., \u0026amp; Zhan, Q. (2021). Risk Factors of Mortality From Pneumocystis Pneumonia in Non-HIV Patients: A Meta-Analysis. Frontiers in public health, 9, 680108. https://doi.org/10.3389/fpubh.2021.680108\u003c/li\u003e\n\u003cli\u003eRapoport, B. L., Cooksley, T., Johnson, D. B., Anderson, R., \u0026amp; Shannon, V. R. (2021). Treatment of infections in cancer patients: an update from the neutropenia, infection and myelosuppression study group of the Multinational Association for Supportive Care in Cancer (MASCC). Expert review of clinical pharmacology, 14(3), 295\u0026ndash;313. https://doi.org/10.1080/17512433.2021.1884067\u003c/li\u003e\n\u003cli\u003eCooley, L., Dendle, C., Wolf, J., Teh, B. W., Chen, S. C., Boutlis, C., \u0026amp; Thursky, K. A. (2014). Consensus guidelines for diagnosis, prophylaxis and management of Pneumocystis jirovecii pneumonia in patients with haematological and solid malignancies, 2014. Internal medicine journal, 44(12b), 1350\u0026ndash;1363. https://doi.org/10.1111/imj.12599\u003c/li\u003e\n\u003cli\u003eWang, H., Zhou, H., Jiang, R., Qian, Z., Wang, F., \u0026amp; Cao, L. (2021). Globulin, the albumin-to-globulin ratio, and fibrinogen perform well in the diagnosis of Periprosthetic joint infection. BMC musculoskeletal disorders, 22(1), 583. https://doi.org/10.1186/s12891-021-04463-7\u003c/li\u003e\n\u003cli\u003eSuh, B., Park, S., Shin, D. W., Yun, J. M., Keam, B., Yang, H. K., Ahn, E., Lee, H., Park, J. H., \u0026amp; Cho, B. (2014). Low albumin-to-globulin ratio associated with cancer incidence and mortality in generally healthy adults. Annals of oncology : official journal of the European Society for Medical Oncology, 25(11), 2260\u0026ndash;2266. https://doi.org/10.1093/annonc/mdu274\u003c/li\u003e\n\u003cli\u003eBueno, V., Sant\u0026apos;Anna, O. A., \u0026amp; Lord, J. M. (2014). Ageing and myeloid-derived suppressor cells: possible involvement in immunosenescence and age-related disease. Age (Dordrecht, Netherlands), 36(6), 9729. https://doi.org/10.1007/s11357-014-9729-x\u003c/li\u003e\n\u003cli\u003eHanigan M. H. (2014). Gamma-glutamyl transpeptidase: redox regulation and drug resistance. Advances in cancer research, 122, 103\u0026ndash;141. https://doi.org/10.1016/B978-0-12-420117-0.00003-7\u003c/li\u003e\n\u003cli\u003eMistry, D., \u0026amp; Stockley, R. A. (2010). Gamma-glutamyl transferase: the silent partner?. COPD, 7(4), 285\u0026ndash;290. https://doi.org/10.3109/15412555.2010.496819\u003c/li\u003e\n\u003cli\u003eDu, W. X., Duan, S. F., Chen, J. J., Huang, J. F., Yin, L. M., \u0026amp; Tong, P. J. (2014). Serum bone-specific alkaline phosphatase as a biomarker for osseous metastases in patients with malignant carcinomas: a systematic review and meta-analysis. Journal of cancer research and therapeutics, 10 Suppl, C140\u0026ndash;C143. https://doi.org/10.4103/0973-1482.145842\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable 1.Clinical characteristics of patients with PJP-HIV and PJP-cancer\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.752260397830018%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.338155515370705%\" valign=\"top\"\u003e\n \u003cp\u003eHIV（n=16）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003eCancer（n=27）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003eP-Value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.752260397830018%\" valign=\"top\"\u003e\n \u003cp\u003eAge（years）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.338155515370705%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.752260397830018%\" valign=\"top\"\u003e\n \u003cp\u003eAge group：number\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.338155515370705%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.752260397830018%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.338155515370705%\" valign=\"top\"\u003e\n \u003cp\u003e3（18.8%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e1（3.7%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.752260397830018%\" valign=\"top\"\u003e\n \u003cp\u003e30-55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.338155515370705%\" valign=\"top\"\u003e\n \u003cp\u003e7（43.8%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e6（22.2%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.752260397830018%\" valign=\"top\"\u003e\n \u003cp\u003e55-60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.338155515370705%\" valign=\"top\"\u003e\n \u003cp\u003e3（18.8%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e4（14.8%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.752260397830018%\" valign=\"top\"\u003e\n \u003cp\u003e60-70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.338155515370705%\" valign=\"top\"\u003e\n \u003cp\u003e2（12.5%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e9（33.3%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.752260397830018%\" valign=\"top\"\u003e\n \u003cp\u003e70-80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.338155515370705%\" valign=\"top\"\u003e\n \u003cp\u003e1（6.25%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e7（25.9%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.752260397830018%\" valign=\"top\"\u003e\n \u003cp\u003eSymptom：number\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.338155515370705%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.752260397830018%\" valign=\"top\"\u003e\n \u003cp\u003eFever\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.338155515370705%\" valign=\"top\"\u003e\n \u003cp\u003e12（81.25%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e17（62.96%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e0.212\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.752260397830018%\" valign=\"top\"\u003e\n \u003cp\u003eCough expectoration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.338155515370705%\" valign=\"top\"\u003e\n \u003cp\u003e10（62.5%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e17（63.0%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e0.976\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.752260397830018%\" valign=\"top\"\u003e\n \u003cp\u003eChest distress\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.338155515370705%\" valign=\"top\"\u003e\n \u003cp\u003e6（37.5%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e15（55.6%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e0.252\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.752260397830018%\" valign=\"top\"\u003e\n \u003cp\u003eAsthma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.338155515370705%\" valign=\"top\"\u003e\n \u003cp\u003e3（18.8%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e11（40.7%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e0.137\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.752260397830018%\" valign=\"top\"\u003e\n \u003cp\u003eDyspnea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.338155515370705%\" valign=\"top\"\u003e\n \u003cp\u003e3（18.8%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e2（7.4%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e0.262\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.752260397830018%\" valign=\"top\"\u003e\n \u003cp\u003eUse of ventilator\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.338155515370705%\" valign=\"top\"\u003e\n \u003cp\u003e0(0%) \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e3(11.1%) \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.752260397830018%\" valign=\"top\"\u003e\n \u003cp\u003eICU Admission\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.338155515370705%\"\u003e\n \u003cp\u003e5（31.3%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\"\u003e\n \u003cp\u003e21（77.8%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"28.752260397830018%\" valign=\"top\"\u003e\n \u003cp\u003eLength of stay\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.338155515370705%\"\u003e\n \u003cp\u003e13.3(41.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\"\u003e\n \u003cp\u003e19.0(58.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e0.187\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 2.Comparison of chest imaging findings\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"600\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.352253756260435%\" rowspan=\"2\"\u003e\n \u003cp\u003eGroup\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.5575959933222%\" colspan=\"3\"\u003e\n \u003cp\u003emediastinal lymphadenopathy\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.851419031719532%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.3873121869783%\" colspan=\"3\"\u003e\n \u003cp\u003ePleural cavity\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003ePJP-HIV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003ePJP-cancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" align=\"left\" width=\"794\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.575031525851198%\" rowspan=\"2\"\u003e\n \u003cp\u003eGroup\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.103404791929382%\" colspan=\"3\"\u003e\n \u003cp\u003eGGO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.19672131147541%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.4640605296343%\" colspan=\"3\"\u003e\n \u003cp\u003eFocal attenuation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.19672131147541%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.4640605296343%\" colspan=\"3\"\u003e\n \u003cp\u003eMaximum lesion range\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eBilateral\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eUnilateral\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eGround-geass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003emixture\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e≦3.0cm\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026gt;3.0cm\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003ePJP-HIV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003ePJP-cancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eGGO\u0026nbsp;represents ground glass opacity.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable3.Variables with significant differences between HIV and Cancer groups\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"600\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\" valign=\"top\"\u003e\n \u003cp\u003eHIV group\u003c/p\u003e\n \u003cp\u003e(n = 16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\" valign=\"top\"\u003e\n \u003cp\u003eCancer group\u003c/p\u003e\n \u003cp\u003e(n = 27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\" valign=\"top\"\u003e\n \u003cp\u003ep-Value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\" valign=\"top\"\u003e\n \u003cp\u003eAUROC\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eMales/Females\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\" valign=\"top\"\u003e\n \u003cp\u003e14/2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\" valign=\"top\"\u003e\n \u003cp\u003e21/6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\" valign=\"top\"\u003e\n \u003cp\u003e48.00±3.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\" valign=\"top\"\u003e\n \u003cp\u003e60.11±2.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\" valign=\"top\"\u003e\n \u003cp\u003e0.011\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\" valign=\"top\"\u003e\n \u003cp\u003e0.753\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eComplete Blood Count:\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eWBC (×10^9/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\" valign=\"bottom\"\u003e\n \u003cp\u003e5.77±2.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\" valign=\"bottom\"\u003e\n \u003cp\u003e6.36（3.41,11.64）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.482\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.565\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eRBC (×10^12/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\" valign=\"bottom\"\u003e\n \u003cp\u003e3.77±0.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\" valign=\"bottom\"\u003e\n \u003cp\u003e3.77±0.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.528\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.582\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eHb (g/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\" valign=\"bottom\"\u003e\n \u003cp\u003e112.44±15.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\" valign=\"bottom\"\u003e\n \u003cp\u003e112.44±15.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.448\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.531\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eHCT (L/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.34±0.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.34±0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.361\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.507\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eMCV (fL)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\" valign=\"bottom\"\u003e\n \u003cp\u003e90.08±5.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\" valign=\"bottom\"\u003e\n \u003cp\u003e90.08±5.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.716\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eMCH (pg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\" valign=\"bottom\"\u003e\n \u003cp\u003e30.03±1.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\" valign=\"bottom\"\u003e\n \u003cp\u003e30.6（29.4,31.7）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.131\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.639\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eMCHC (g/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\" valign=\"bottom\"\u003e\n \u003cp\u003e331.5（329.25,335.25）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\" valign=\"bottom\"\u003e\n \u003cp\u003e333.25±7.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.667\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eRDW\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\" valign=\"bottom\"\u003e\n \u003cp\u003e13.3（12.4,14.45）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\" valign=\"bottom\"\u003e\n \u003cp\u003e15.9（13.7,17.8）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.81\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003ePLT (×10^9/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\" valign=\"bottom\"\u003e\n \u003cp\u003e239±105.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\" valign=\"bottom\"\u003e\n \u003cp\u003e175（144，229）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.056\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.676\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eMPV (fL)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\" valign=\"bottom\"\u003e\n \u003cp\u003e10.51±1.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\" valign=\"bottom\"\u003e\n \u003cp\u003e10.51±1.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.241\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.527\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003ePCT (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.24±0.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.17（0.14,0.22）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.689\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003ePDW (fl)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\" valign=\"bottom\"\u003e\n \u003cp\u003e13.91±3.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\" valign=\"bottom\"\u003e\n \u003cp\u003e16.1（12.2,16.5）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.155\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.631\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eLYMPH# (×10^9/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.81±0.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.81±0.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.151\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.542\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eMONO# (×10^9/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.39±0.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.38(0.17,0.53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.506\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eNEUT# (×10^9/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\" valign=\"bottom\"\u003e\n \u003cp\u003e4.42±1.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\" valign=\"bottom\"\u003e\n \u003cp\u003e5.41(2.38,9.54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.421\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.574\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eEOS# (×10^9/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.13±0.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.08(0.01,0.16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.246\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.606\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eBASO# (×10^9/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.02±0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.01(0.01,0.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.205\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.608\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eCRP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\" valign=\"bottom\"\u003e\n \u003cp\u003e42.08±39.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\" valign=\"bottom\"\u003e\n \u003cp\u003e53.11(19.32,108.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.588\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eALT (U/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\"\u003e\n \u003cp\u003e13.80(11.50,26.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\"\u003e\n \u003cp\u003e22.00(16.00,36.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\"\u003e\n \u003cp\u003e0.018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\"\u003e\n \u003cp\u003e0.724\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eAST (U/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\"\u003e\n \u003cp\u003e31.45(22.50,40.93)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\"\u003e\n \u003cp\u003e35.00(23.00,49.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\"\u003e\n \u003cp\u003e0.466\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\"\u003e\n \u003cp\u003e0.744\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eT-BIL (umol/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\"\u003e\n \u003cp\u003e7.40(6.33,8.78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\"\u003e\n \u003cp\u003e9.20(6.20,17.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\"\u003e\n \u003cp\u003e0.213\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\"\u003e\n \u003cp\u003e0.596\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eD-BIL (umol/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\"\u003e\n \u003cp\u003e2.25(1.58,3.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\"\u003e\n \u003cp\u003e2.50(1.60,6.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\"\u003e\n \u003cp\u003e0.237\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\"\u003e\n \u003cp\u003e0.580\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eTP (g/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\"\u003e\n \u003cp\u003e69.83±2.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\"\u003e\n \u003cp\u003e62.05±1.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\"\u003e\n \u003cp\u003e0.657\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eALB (g/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\"\u003e\n \u003cp\u003e31.60±1.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\"\u003e\n \u003cp\u003e33.44±0.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\"\u003e\n \u003cp\u003e0.261\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\"\u003e\n \u003cp\u003e0.580\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eGLB (g/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\"\u003e\n \u003cp\u003e38.23±1.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\"\u003e\n \u003cp\u003e28.61±1.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\"\u003e\n \u003cp\u003e0.788\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eA/G\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\"\u003e\n \u003cp\u003e0.85(0.65,0.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\"\u003e\n \u003cp\u003e1.17(0.97,1.53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\"\u003e\n \u003cp\u003e0.769\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eγ-GGT (U/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\"\u003e\n \u003cp\u003e23.00(19.25,36.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\"\u003e\n \u003cp\u003e48.00(24.00,200.10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\"\u003e\n \u003cp\u003e0.023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\"\u003e\n \u003cp\u003e0.641\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eALP (U/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\"\u003e\n \u003cp\u003e79.5(61.20,101.375)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\"\u003e\n \u003cp\u003e104.80(78.10,219.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\"\u003e\n \u003cp\u003e0.012\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\"\u003e\n \u003cp\u003e0.827\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eCr (umol/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\"\u003e\n \u003cp\u003e65.20(54.60,81.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\"\u003e\n \u003cp\u003e63.80(44.90,86.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\"\u003e\n \u003cp\u003e0.498\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\"\u003e\n \u003cp\u003e0.622\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eUREA (mmol/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\"\u003e\n \u003cp\u003e4.50(3.29,5.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\"\u003e\n \u003cp\u003e5.40(3.70,7.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\"\u003e\n \u003cp\u003e0.163\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\"\u003e\n \u003cp\u003e0.721\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eUA (umol/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\"\u003e\n \u003cp\u003e293.94±26.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\"\u003e\n \u003cp\u003e272.24±18.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\"\u003e\n \u003cp\u003e0.493\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\"\u003e\n \u003cp\u003e0.526\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eTC (mmol/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\"\u003e\n \u003cp\u003e3.73±0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\"\u003e\n \u003cp\u003e4.74±0.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\"\u003e\n \u003cp\u003e0.009\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\"\u003e\n \u003cp\u003e0.760\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eTG (mmol/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\"\u003e\n \u003cp\u003e1.04(0.80,1.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\"\u003e\n \u003cp\u003e1.7(1.16,2.79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\"\u003e\n \u003cp\u003e0.016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\"\u003e\n \u003cp\u003e0.731\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eCK (U/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\" valign=\"top\"\u003e\n \u003cp\u003e37.20(23.25, 2.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\" valign=\"top\"\u003e\n \u003cp\u003e42.10(32.00, 64.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\" valign=\"top\"\u003e\n \u003cp\u003e0.291\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\" valign=\"top\"\u003e\n \u003cp\u003e0.597\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eCK-MB (U/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\" valign=\"top\"\u003e\n \u003cp\u003e15.40(12.85, 2.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\" valign=\"top\"\u003e\n \u003cp\u003e17.80(12.10, 23.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\" valign=\"top\"\u003e\n \u003cp\u003e0.606\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\" valign=\"top\"\u003e\n \u003cp\u003e0.547\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eLDH (U/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\" valign=\"top\"\u003e\n \u003cp\u003e355.94±123.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\" valign=\"top\"\u003e\n \u003cp\u003e416.36±183.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\" valign=\"top\"\u003e\n \u003cp\u003e0.112\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\" valign=\"top\"\u003e\n \u003cp\u003e0.593\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eD-Dimer (mg/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\" valign=\"top\"\u003e\n \u003cp\u003e1.01 (0.81, 1.16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\" valign=\"top\"\u003e\n \u003cp\u003e0.63 (0.32, 6.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\" valign=\"top\"\u003e\n \u003cp\u003e0.716\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\" valign=\"top\"\u003e\n \u003cp\u003e0.534\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003ePT (s)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\" valign=\"top\"\u003e\n \u003cp\u003e11.90(11.20,12.53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\" valign=\"top\"\u003e\n \u003cp\u003e11.90(10.70, 12.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\" valign=\"top\"\u003e\n \u003cp\u003e0.772\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\" valign=\"top\"\u003e\n \u003cp\u003e0.527\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003ePTA (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\" valign=\"top\"\u003e\n \u003cp\u003e102.77±12.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\" valign=\"top\"\u003e\n \u003cp\u003e99.60±23.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\" valign=\"top\"\u003e\n \u003cp\u003e0.081\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\" valign=\"top\"\u003e\n \u003cp\u003e0.554\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eINR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\" valign=\"top\"\u003e\n \u003cp\u003e1.01 (0.93, 1.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\" valign=\"top\"\u003e\n \u003cp\u003e1.03 (0.95, 1.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\" valign=\"top\"\u003e\n \u003cp\u003e0.352\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\" valign=\"top\"\u003e\n \u003cp\u003e0.586\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eAPTT (s)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\" valign=\"top\"\u003e\n \u003cp\u003e31.86±6.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\" valign=\"top\"\u003e\n \u003cp\u003e27.69±4.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\" valign=\"top\"\u003e\n \u003cp\u003e0.138\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\" valign=\"top\"\u003e\n \u003cp\u003e0.694\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eFIB (g/L)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\" valign=\"top\"\u003e\n \u003cp\u003e4.97±1.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\" valign=\"top\"\u003e\n \u003cp\u003e4.45±1.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\" valign=\"top\"\u003e\n \u003cp\u003e0.869\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\" valign=\"top\"\u003e\n \u003cp\u003e0.600\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"24.540901502504173%\" valign=\"top\"\u003e\n \u003cp\u003eTT (s)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.21035058430718%\" valign=\"top\"\u003e\n \u003cp\u003e16.85(15.83, 7.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.37395659432387%\" valign=\"top\"\u003e\n \u003cp\u003e15.80(13.60, 16.90)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.853088480801336%\" valign=\"top\"\u003e\n \u003cp\u003e0.100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.021702838063439%\" valign=\"top\"\u003e\n \u003cp\u003e0.652\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\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":"Pneumocystis jirovecii pneumonia, HIV, Cancer, Clinical characteristics, Imaging features","lastPublishedDoi":"10.21203/rs.3.rs-3065296/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3065296/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective: \u003c/strong\u003eTo retrospectively compare the clinical, laboratory, and imaging features of \u003cem\u003ePneumocystis\u003c/em\u003e jirovecii pneumonia among HIV-infected individuals and patients with cancer in order to provide evidence for early detection, diagnosis, and treatment.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e Fourty-three patients with PJP diagnosed at the First Affiliated Hospital of Nanchang University from January 2017 to August 2022 were enrolled. \u003cem\u003ePneumocystis \u003c/em\u003ejirovecii pneumonia patients were divided into an HIV-infected group and a cancer group.A retrospective comparative analysis of clinical, laboratory, and imaging features was conducted in both groups.Statistical analysis using SPSS version 26.0 was performed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eClinical indicators such as total protein, globulin,the ratio of albumin to globulin(AGR),γ-glutamyl transpeptidase(γ-GGT),alkaline phosphatase, triglyceride, total cholesterol,and blood glucose were statistically different in PJP-HIV and PJP-cancer.PJP-HIV patients mainly presented with upper respiratory symptoms, generally with fever as the first symptom,whereas the majority of PJP-cancer patients had systemic symptoms.Furthermore,PJP-HIV patients demonstrated early clinical and radiologic characteristics of lung diseases,while PJP-cancer patients had a later appearance.PJP-cancer patients had a longer length of hospital stay(58.8%,P=0.187),a higher rate of mechanical ventilation(11.1%,P＜0.05),and a higher probability of ICU admission（77.8%,P＜0.05）compared with PJP-HIVpatients.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePJP-HIV patients presented with non-systemic symptoms and early abnormal lung imaging features, while PJP-cancer patients presented with systemic symptoms and late abnormal lung imaging features. Laboratory data for both groups, however, show significant statistical significance.\u003c/p\u003e","manuscriptTitle":"Retrospective comparative analysis of clinical, laboratory, and imaging features of Pneumocystis jirovecii pneumonia among HIV-infected individuals and patients with cancer","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-08-04 23:39:04","doi":"10.21203/rs.3.rs-3065296/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":"dc5a1144-1a82-4414-92f7-79a26a1169b1","owner":[],"postedDate":"August 4th, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2023-08-25T17:29:12+00:00","versionOfRecord":[],"versionCreatedAt":"2023-08-04 23:39:04","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3065296","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3065296","identity":"rs-3065296","version":["v1"]},"buildId":"FbvkV6FR0MCFSLy54lSbu","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}