卡波氏肉瘤的第五种亚型，男男性行为者中的经典卡波氏肉瘤：巴黎的一项队列研究。

A fifth subtype of Kaposi's sarcoma, classic Kaposi's sarcoma in men who have sex with men: a cohort study in Paris.

机构信息

Service de Dermatologie, Hôpital Cochin, APHP, France et Université Paris Descartes, Paris, France.

出版信息

J Eur Acad Dermatol Venereol. 2018 Aug;32(8):1377-1384. doi: 10.1111/jdv.14831. Epub 2018 Feb 14.

DOI:10.1111/jdv.14831

PMID:29377280

Abstract

BACKGROUND

Classic Kaposi's sarcoma (CKS) occurs predominantly among elderly men and is associated with Kaposi's sarcoma-associated herpesvirus (KSHV). In low-endemic countries, KSHV infects predominantly men having sex with men (MSM).

OBJECTIVES

To describe a cohort of classic Kaposi sarcoma in a low-endemic area for KSHV, to highlight the features of CKS in MSM and identify prognostic factors.

METHODS

Retrospective single-centre study of CKS cases. We compared MSM to heterosexual patients. Then, we divided the patients into two subgroups, those requiring a systemic treatment and the others, and we performed univariate and multivariate analyses to determine aggressiveness of CKS.

RESULTS

Between 2006 and 2015, seventy-four patients were included. Mean age at diagnosis was 68.9 years; sex ratio (M/F) was 6.4, and 28% were MSM; MSM patients were younger (P = 0.02), less often originated from endemic areas (P < 0.0001). KS was less severe (P = 0.04), required more often a local treatment than a systemic one (P = 0.03). On multivariate analysis, CD4 T-cell count > 500/mm at baseline was associated with a reduced risk of severe evolution.

CONCLUSION

First CKS cohort in low-endemic zone. We describe a fifth subtype of KS: KS in MSM. The CD4 T-cell count was found to correlate with prognosis.

摘要

背景

经典卡波西肉瘤（CKS）主要发生在老年男性中，与卡波西肉瘤相关疱疹病毒（KSHV）有关。在低流行地区，KSHV 主要感染男男性行为者（MSM）中的男性。

目的

描述低流行地区 KSHV 感染经典卡波西肉瘤的队列，强调 MSM 中 CKS 的特征，并确定预后因素。

方法

回顾性单中心 CKS 病例研究。我们比较了 MSM 和异性恋患者。然后，我们将患者分为需要全身治疗和不需要全身治疗两个亚组，进行单因素和多因素分析，以确定 CKS 的侵袭性。

结果

在 2006 年至 2015 年期间，共纳入 74 例患者。诊断时的平均年龄为 68.9 岁；男女比例（M/F）为 6.4，28%为 MSM；MSM 患者年龄较小（P = 0.02），较少来自流行地区（P < 0.0001）。KS 较轻（P = 0.04），更常需要局部治疗而非全身治疗（P = 0.03）。多因素分析显示，基线时 CD4 T 细胞计数＞500/mm 与严重进展风险降低相关。