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艾滋病相关恶性肿瘤。

AIDS-associated malignancies.

作者信息

Akanmu A S

机构信息

Department of Haematology and Blood Transfusion, College of Medicine, University of Lagos, Nigeria.

出版信息

Afr J Med Med Sci. 2006 Dec;35 Suppl:57-70.

Abstract

A number of immunodeficiency states--both inherited (such as agammaglobulinaemia, Bloom's syndrome, hereditary telangiectasia) and acquired (e.g. immunosuppressive therapy) have been associated with varieties of cancers. HIV induces more profound immunodeficiency state and it should not be difficult to imaging why cancer diagnosis is made in over 40% of HIV infected patients. Impairment of normal function of natural killer cells as a result of lack of helper signals from CD4+ T-lymphocytes may be a major mechanism of increased susceptibility to cancer development in HIV infected patients. Although many neoplastic diseases could occur at a frequency not higher than would be expected by chance alone, the biological behaviour of such malignancies tend to be more aggressive. Three neoplastic diseases are associated so commonly with HIV infection that each of them has become recognized as an AIDS defining illness. These are Kaposi's Sarcoma (KS), Non-Hodgkin's Lymphoma (NHL) and Cervical Carcinoma. Both KS and NHL were recognized as AIDS associated cancers from the onset of the epidemic in 1981 but carcinoma of the cervix became AIDS defining in 1993. The epidemiology, aetiopathogenesis, clinical manifestation, diagnostic tools and modalities of therapeutic intervention for KS and NHL form the subject of this review.

摘要

许多免疫缺陷状态——包括遗传性的(如无丙种球蛋白血症、布卢姆综合征、遗传性毛细血管扩张症)和后天获得性的(如免疫抑制治疗)——都与多种癌症有关。HIV会导致更严重的免疫缺陷状态,因此不难想象为什么超过40%的HIV感染患者会被诊断出患有癌症。由于缺乏来自CD4+T淋巴细胞的辅助信号,自然杀伤细胞的正常功能受损,这可能是HIV感染患者患癌易感性增加的主要机制。尽管许多肿瘤性疾病的发生频率可能并不高于仅由偶然因素预期的频率,但这类恶性肿瘤的生物学行为往往更具侵袭性。有三种肿瘤性疾病与HIV感染非常常见地相关联,以至于它们每一种都已被确认为艾滋病定义疾病。这些疾病是卡波西肉瘤(KS)、非霍奇金淋巴瘤(NHL)和宫颈癌。KS和NHL从1981年艾滋病流行开始就被确认为与艾滋病相关的癌症,但宫颈癌在1993年成为艾滋病定义疾病。KS和NHL的流行病学、病因发病机制、临床表现、诊断工具以及治疗干预方式构成了本综述的主题。

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