Friedman-Kien A E, Saltzman B R
Department of Dermatology and Microbiology, New York University Medical Center, NY 10016.
J Am Acad Dermatol. 1990 Jun;22(6 Pt 2):1237-50. doi: 10.1016/0190-9622(90)70169-i.
Kaposi's sarcoma, first described in 1972, is a rare, chronic neoplasm that occurs most often in elderly men of Eastern European origin. In the mid-twentieth century, more aggressive forms of Kaposi's sarcoma were found to be an endemic disease especially common among young black men in central Africa. Kaposi's sarcoma also occurs in iatrogenically immunosuppressed patients, such as kidney transplant recipients. In 1981, the sudden occurrence of an unusual, disseminated form of Kaposi's sarcoma in homosexual men in New York and California heralded the epidemic now known as the acquired immunodeficiency syndrome (AIDS). Ninety-five percent of all AIDS-associated Kaposi's sarcoma (AIDS-KS) has been in homosexual men; however, the incidence of AIDS-KS has diminished from greater than 40% of men with AIDS since 1981 to less than 20% in 1989. The remaining 5% of AIDS-KS has been seen in all other populations at risk for AIDS. The reasons for the remarkable persistent increased prevalence of AIDS-KS among homosexual men remains obscure. Clinically, AIDS-KS is a highly varied neoplastic disease characterized by multifocal mucocutaneous lesions often with lymphatic and visceral involvement. The etiology of Kaposi's sarcoma remains unknown although various hypotheses have been suggested, including endothelial-tumor growth factors, oncogenic expression, genetic predisposition, and environmental cofactors. An as-yet unidentified viruslike agent has been proposed as a possible direct cause of this neoplasm. Different treatment modalities for Kaposi's sarcoma have been employed with varying success, these include localized radiation therapy, cryotherapy, electrocauterization, surgical excision, and a variety of systemic chemotherapeutic regimens, as well as alpha-interferon. Although all available treatments help control the lesions, none lengthens survival.
卡波西肉瘤于1972年首次被描述，是一种罕见的慢性肿瘤，最常发生于东欧裔老年男性。在20世纪中叶，发现侵袭性更强的卡波西肉瘤是一种地方病，在中非年轻黑人男性中尤为常见。卡波西肉瘤也发生在医源性免疫抑制患者中，如肾移植受者。1981年，纽约和加利福尼亚的同性恋男性中突然出现一种异常的、播散性的卡波西肉瘤，预示着现在被称为获得性免疫缺陷综合征（艾滋病）的流行。所有与艾滋病相关的卡波西肉瘤（艾滋病相关卡波西肉瘤）中有95%发生在同性恋男性中；然而，艾滋病相关卡波西肉瘤的发病率已从1981年以来艾滋病男性患者中超过40%降至1989年的不到20%。其余5%的艾滋病相关卡波西肉瘤见于所有其他有艾滋病风险的人群中。同性恋男性中艾滋病相关卡波西肉瘤患病率持续显著上升的原因仍不清楚。临床上，艾滋病相关卡波西肉瘤是一种高度多样化的肿瘤性疾病，其特征是多灶性黏膜皮肤病变，常伴有淋巴和内脏受累。卡波西肉瘤的病因仍然不明，尽管提出了各种假说，包括内皮肿瘤生长因子、致癌基因表达、遗传易感性和环境辅助因素。一种尚未鉴定的类病毒因子被认为可能是这种肿瘤的直接病因。已采用不同的卡波西肉瘤治疗方式，效果各异，这些包括局部放射治疗、冷冻疗法、电烙术、手术切除、各种全身化疗方案以及α干扰素。尽管所有可用的治疗方法都有助于控制病变，但没有一种能延长生存期。
