艾滋病相关性卡波西肉瘤新进展

卡波西肉瘤(Kaposi’s sarcoma,KS)又称多发性特发性出血性肉瘤,是一种多中心起源的由血管和梭形细胞混合组成的恶性肿瘤。目前,人类免疫缺陷病毒(Human Immunodeficiency Virus,HIV)感染导致的严重免疫功能缺陷而引起各种机会性感染和(或)恶性肿瘤中,KS是最常见的艾滋病(acquired immunodeficiency syndrome,AIDS)相关肿瘤。KS可分为四种形:古典型KS,由匈牙利医生Moritz Kaposi于1872年报道,     

人类疱疹病毒8型诊断学的研究进展

HHV-8又名Kaposi肉瘤相关疱疹病毒（Kaposi’s sarcoma-associated herpesvirus，KSHV），是Kaposi肉瘤（Kaposi’s sarcoma，KS）、原发性渗出型淋巴瘤（Primary effusion lymphoma，PEI。）以及多中心性Castleman病（multicentric Castleman disease，MCD）的重要病原体。它是由Chang等1994年采用代表性差异分析法从1例AIDS相关性KS患者的KS病变组织中发现的。本文就近年来HHV-8的生物学特性及其诊断学的研究进展综述如下。     

人疱疹病毒8型流行病学研究进展

1994年,Chang Y等在艾滋病相关型卡波氏肉瘤病人的病损组织中发现卡波氏肉瘤相关疱疹病毒(Kaposi sarcoma-associated herpesvirus, 也被称为human herpesvirus type 8,KSHV/HHV-8),定义为新的人疱疹病毒,HHV-8属γ疱疹病毒属.HHV-8在各型卡波西肉瘤(Kaposi's sarcoma,KS)(经典型、艾滋病相关型、非洲地方型、肾移植/免疫抑制相关型 )中都被检测到,目前认为是KS的主要病因[1～2].     

Kaposi肉瘤患者病情进展与HHV-8病毒载量相关性的研究进展

Kaposi肉瘤（Kaposi’s sarcoma，KS）、部分多中心血管滤泡淋巴增生症（multi—centriccastle—man’s disease，MCD）和原发性渗出性淋巴瘤（primary effusion lymphoma，PEL）等和AIDS相关恶性肿瘤的发生与人类疱疹病毒8型（Human Herpesvirus-8，HHV-8）密切相关[1]。HHV-8是一种重要的具有高度致癌性的人类肿瘤病毒，在HHV．8相关的疾病中，KS最为多见。研究表明，在Kaposi肉瘤患者的瘤组织中，HHV．8DNA检出率为80％～100％[2]。随着实时荧光定量     

中西医结合治疗艾滋病合并卡波西肉瘤1例

<正>Kaposi肉瘤(Kaposi sarcoma,KS)又称为多发性出血性肉瘤,这是一种分化较好的,由血管增生导致的多发性恶性肿瘤多发生于50岁以上的老年男性,在我国KS主要发生于新疆地区少数民族,汉族人较少见。现将广州市第八人民医院自成立     

淋巴结Kaposi′s肉瘤(附16例报告)

淋巴结是Kaposi′s肉瘤(KS)最常受累的器官,组织图像与皮肤KS相同。淋巴结KS可直接由KS累及,或为皮肤KS所伴发。本文16例中有3例伴有皮肤KS。1例淋巴结活检后检测HIV抗体证实为AIDS,故认为活检和血清HIV抗体检测对发现和诊断AIDS具有重要意义。     

人疱疹病毒8型在HIV相关型Kaposi肉瘤发病机制中作用的研究进展

1994年人疱疹病毒8型(HHV -8)被确定为具有某些人Kaposi肉瘤(KS)的感染性因素后,几乎在所有类型的KS中均可观察到HHV -8感染.之后人们对HHV -8的病毒学、致病机制及临床预后进行了广泛、深入的研究.1人疱疹病毒8型相关型卡波西肉瘤(KS)概述KS是一种血管源性肿瘤,又称多发性、特发性出血性肉瘤.自Kaposi氏于1872年报告本病至今已有100余年的历史,有关KS的病因学一直未能确定.按照Kaposi描述的多中心发生,全身皮肤及内脏血管广泛受累,紫色的结节性皮肤皮损,被称为经典的KS.     

卡波氏肉瘤病因学的研究进展

卡波氏肉瘤（Kaposi＇s sarcoma，KS）是一种缓慢进展的软组织恶性多发性色素性血管肉瘤，主要见于皮肤，也可累及内脏。根据临床表现、生物行为及特点不同可分为经典型、艾滋病相关型、非洲地方型、免疫抑制／器官移植相关型。KS病因学一直未能确定，KS是AIDS的早期表现之一，也是艾滋病（AIDS）最常见的原发性肿瘤和致死原因，鉴于其对AIDS的特殊价值，KS引起广泛关注。现将其病因学的研究进展综述如下。     

AIDS相关型Kaposi肉瘤

Kaposi肉瘤(Kapo’s sarcorna)又称复发性特发性出血性肉瘤，1872年由Kaposi首先报道，故名。1981年科学家发现部分Kaposi肉瘤的发生与爱滋病(AIDS)有关，称为AIDS相关型Kaposi肉瘤(AIDS—KS)，主要见于男性同性恋者中，约有30％是作为AIDS最初的皮肤表现发生的，     

艾滋病患者的口腔损害及其在艾滋病诊断中的作用

对7例艾滋病患者（HIV抗体阳性）进行口腔检查，以了解口腔损害与艾滋病的关系，为研究口腔损害作为艾滋病的临床标志物提供资料。结果表明：7例艾滋病患者的主要口腔损害是：口腔溃疡6例、白色念珠菌病4例、牙周炎4例、卡波济氏肉瘤3例、带状疱疹3例、毛状白斑2例、单纯疱疹性口炎2例以及淋巴结肿大3例。口腔溃疡患病率最高，白色念珠菌病最明显，其次为牙周炎。研究提示，艾滋病患者可以出现明显的口腔损害，了解艾滋病患者的口腔损害不仅利于艾滋病患者的早期发现和正确处理，也有利于口腔医务人员自身的防护。     

Monitoring of endogenous interferon-alpha and human herpesvirus 8 in HIV-infected patients with Kaposi's sarcoma

The incidence of AIDS-associated Kaposi's sarcoma has declined since the mid-nineties due to the availability of potent antiretroviral therapy including protease inhibitors. However, Kaposi's sarcoma is still the most common neoplasia in HIV-infected patients. In the pathogenesis of the HIV-associated as well as other forms of this disease an infectious agent seems to play a role, namely the human herpesvirus 8. Even before the discovery of the HIV virus, high levels of an unusual acid-labile form of endogenous interferon alpha were found in patients with AIDS-associated KS. The administration of recombinant interferon alpha evolved as standard therapy for Kaposi's sarcoma in HIV-infected patients with a moderate immunodeficiency in addition to antiretroviral therapy. This investigation monitored the levels of HHV 8 and endogenous interferon in 4 patients with and without Kaposi's sarcoma during the course of HIV-disease. The results of our experiments lead us to two hypotheses: First of all, the pre-therapeutic level of endogenous interferon may be a predictor of the response to an interferon-alpha therapy for HIV-associated Kaposi's sarcoma. Secondly, the determination of HHV 8 DNA in blood of HIV-positive patients may allow conclusions about the risk for the development of Kaposi's sarcoma. However these hypotheses should be tested by monitoring the levels of endogenous interferon and HHV 8 DNA in clinical studies of a greater number of HIV-infected patients.     

Classic Kaposi's sarcoma

Classic Kaposi's sarcoma is one form of Kaposi's sarcoma. It is usually first seen in the skin of the lower extremities, where it is frequently misdiagnosed as a bruise. As time progresses, the lesions increase in size, number, and color. Early diagnosis is paramount to decrease metastasis to other organ systems such as the lungs, kidneys, and liver. The podiatric physician must take a detailed history, follow the course of the illness, and be aware that definitive diagnosis is made by a skin biopsy. This article provides a case history of Kaposi's sarcoma and discusses diagnosis and treatment of this disease.     

Upper gastrointestinal Kaposi's sarcoma in patients positive for HIV antibody without cutaneous disease

Six patients with antibodies to the human immunodeficiency virus (HIV) and with persistent gastrointestinal symptoms of HIV infection but without cutaneous lesions of Kaposi's sarcoma underwent endoscopy. Four also underwent barium meal examination. In all six cases small lesions were seen in the stomach at endoscopy, and histological examination of biopsy specimens taken from the lesions confirmed the diagnosis of Kaposi's sarcoma. The barium meal examinations were reported as normal in three patients and showed oesophageal candidiasis in the fourth. These findings suggest that Kaposi's sarcoma of the upper gastrointestinal tract is common in patients positive for HIV antibody, even those without cutaneous lesions. Endoscopy, with biopsy of suspicious lesions, is necessary to make the diagnosis and is recommended in all HIV antibody positive patients with persistent upper gastrointestinal symptoms.     

A clinical study of 100 cases of AIDS in Africa]

In this article, 100 cases of AIDS observed in Africa by the Chinese Medical Team are reported. The general clinical data were analyzed and studied, and the changes in the oral cavity and on the skin (Kaposi's sarcoma) are described. The results showed that oral mycotic infection and Kaposi's sarcoma are the strong evidences of this immunity deficiency and may be regarded as the early stage clinical manifestations of AIDS in Africa.     

获得性免疫缺陷综合征的肺部病变：151例尸检材料病理学研究

研究纽约ＭｏｕｎｔＳｉｎａｉ医学中心１５１例尸检材料的肺部病变，旨在概括艾滋病患者肺剖病学的频谱及其病理特征，所有病例均按常规解剖、取材、福尔马林固定，石蜡包埋，苏木素伊红染色。必要时作组织化学染色和免疫组化研究。     

艾滋病合并恶性肿瘤10例临床病理分析

目的:分析艾滋病(AIDS)合并恶性肿瘤的临床与病理特点。方法:对会诊和复查的48例AIDS患者的病理活检与尸检材料进行临床、影像、解剖与病理对照研究。结果:48例AIDS患者中合并恶性肿瘤10例;其中儿童2例系母婴传播;成年人8例中经输血传播4例。合并非霍奇金淋巴瘤4例,乳腺癌2例,卡波西肉瘤1例,肝母细胞瘤1例,食管癌1例,肾癌1例。结论:AIDS患者易合并恶性肿瘤,疾病谱广泛,以淋巴瘤多见,确诊需依赖病理检查。     

Length of survival of patients with acquired immune deficiency syndrome in the United Kingdom

An analysis of the lengths of survival of patients with the acquired immune deficiency syndrome presenting with different opportunistic diseases was performed using epidemiological data routinely collected at the PHLS Communicable Disease Surveillance Centre. The overall crude case fatality rate was 55.4% (93/168). The median survival times were: 21.2 months for Kaposi's sarcoma, 12.5 months for Pneumocystis carinii pneumonia, and 13.3 months for other opportunistic infections. The shortest median survival time (6.6 months) was found for those with both Kaposi's sarcoma and P carinii pneumonia. There were significant differences between durations of survival of patients with Kaposi's sarcoma and those with all other diseases, which indicated impaired cellular immunity apart from opportunistic infections. This analysis shows that those with Kaposi's sarcoma alone have the most favourable prognosis.     

艾滋病相关卡波西肉瘤32例尸检材料病理学研究

目的：概况艾滋病相关卡产波西肉瘤（ＫＳ）病理特征，并探讨其两全是学分型、来源与性质。方法：所有病例均按常规尸检及制片，光镜观察，并复习资料。结果：ＫＳ累及皮肤２３例，呼吸系统２０例，消化道１７例，淋巴结１２例，２６例为播散性。肿瘤肉眼表现为斑型和结节型，镜下主要同增生的血管和梭形细胞构成。并常见胶原分、淋这扩张、嗜性小体、炎细胞浸浸、出血及含铁务黄素沉积等特征性病变。结论：ＫＳ是一种颇具特征的病变     

Safety and efficacy of sulfamethoxazole and trimethoprim chemoprophylaxis for Pneumocystis carinii pneumonia in AIDS

The safety and efficacy of sulfamethoxazole and trimethoprim in the prevention of Pneumocystis carinii pneumonia associated with the acquired immunodeficiency syndrome (AIDS) were evaluated. Sixty patients with a new diagnosis of Kaposi's sarcoma and no history of opportunistic infections were randomly assigned to receive 800 mg of sulfamethoxazole and 160 mg of trimethoprim twice per day or no therapy. None of the 30 patients receiving sulfamethoxazole and trimethoprim developed P carinii pneumonia. Sixteen of the 30 patients receiving no suppressive therapy developed P carinii pneumonia. Development of P carinii pneumonia was associated with the stage of Kaposi's sarcoma, B subtype disease, and the presence of 0.20 X 10(9)/L (200/mm3) or fewer CD4 cells at study entry. The proportion of patients surviving and the mean length of survival were significantly greater in the treatment group compared with the control group. Adverse reactions occurred in 15 patients (50%).