高效抗逆转录病毒治疗时代的肺卡波西肉瘤

Pulmonary Kaposi sarcoma in the era of highly active antiretroviral therapy.

作者信息

Palmieri C, Dhillon T, Thirlwell C, Newsom-Davis T, Young A-M, Nelson M, Gazzard B G, Bower M

机构信息

Department of Medical Oncology, The Chelsea and Westminster Hospital, London, UK.

出版信息

HIV Med. 2006 Jul;7(5):291-3. doi: 10.1111/j.1468-1293.2006.00378.x.

DOI:10.1111/j.1468-1293.2006.00378.x

PMID:16945073

Abstract

OBJECTIVE

Since the introduction of highly active antiretroviral therapy (HAART) there has been a dramatic reduction in the incidence of Kaposi sarcoma (KS) and an improvement in survival. We wished to examine whether the outcome in pulmonary KS (pKS) has also altered.

METHODS

In a single-institution cohort of 1140 HIV-positive patients with KS, 305 patients were diagnosed in the HAART era (1996-2004). We examined the clinicopathological features and outcomes of these patients, of whom 25 had pKS and 280 did not.

RESULTS

Patients with pKS had lower CD4 cell counts at the time of KS diagnosis (Mann-Whitney U-test P=0.005). The incidence of pKS was higher in African patients than in non-African patients in this sample (Fisher's test, P=0.001). There were no significant differences in age, gender, plasma HIV-1 viral load or prior HAART treatment at the time of KS diagnosis. Five-year overall survival in the pKS group was 49% [95% confidence interval (CI) 26-73%] as compared with 82% (95% CI 76-87%) for the non-pKS group (log rank, P<0.0001).

CONCLUSION

PKS remains an ominous diagnosis in the era of HAART, with a median survival of just 1.6 years.

摘要

目的

自从高效抗逆转录病毒治疗（HAART）引入以来，卡波西肉瘤（KS）的发病率显著降低，生存率有所提高。我们希望研究肺卡波西肉瘤（pKS）的预后是否也发生了改变。

方法

在一个拥有1140例HIV阳性KS患者的单机构队列中，305例患者在HAART时代（1996 - 2004年）被诊断。我们研究了这些患者的临床病理特征和预后，其中25例患有pKS，280例没有。

结果

pKS患者在KS诊断时的CD4细胞计数较低（曼 - 惠特尼U检验P = 0.005）。在这个样本中，非洲患者的pKS发病率高于非非洲患者（费舍尔检验，P = 0.001）。在KS诊断时，年龄、性别、血浆HIV - 1病毒载量或先前的HAART治疗方面没有显著差异。pKS组的五年总生存率为49%[95%置信区间（CI）26 - 73%]，而非pKS组为82%（95%CI 76 - 87%）（对数秩检验，P < 0.0001）。