Cosnes J, Darmoni S J, Evard D, Le Quintrec Y
Ann Gastroenterol Hepatol (Paris). 1986 May-Jun;22(3):123-8.
45 patients with acquired immunodeficiency syndrome (AIDS) were studied with gastrointestinal endoscopy (42 upper endoscopies and 12 colonoscopies). 28 patients had skin or buccal Kaposi's sarcoma with or without opportunistic infections and 17 had opportunistic infections. 12 patients out of 45 (27 per cent) had 1 or several Kaposi's sarcoma macroscopic gastrointestinal localisations, 12 documented by upper endoscopy and 4 by colonoscopy. Endoscopic biopsies confirmed the diagnosis 5 times out of 16 (31 per cent). 16 patients (38 per cent) had candidosis oesophagitis, 1 had ulcerative antritis, 2 had a erythematosus duodenitis, 6 had diffuse inflammatory mucosal colonic changes. The specific abnormalities documented by histology were 1 case of total villous atrophy and 2 cases of cytomegalovirus colitis. The patients with cutaneous Kaposi's sarcoma have more often shown gastrointestinal Kaposi's sarcoma than the patients without Kaposi's sarcoma. The prevalence of tumoral or major (diffuse candidosis oesophagitis, ulcerative antritis, active colitis) endoscopic abnormalities documented by upper endoscopy was 40 per cent (10 cases out of 25) in asymptomatic patients, 43 per cent in diarrheic patients (3 cases out of 7) and 60 per cent (6 cases out of 10) in patients with dysphagia, epigastralgic pain or vomiting and that of documented by colonoscopy was 75 per cent (3 cases out of 4) in patients with mucus or bloody stools and 14 per cent (1 case out of 7) in diarrheic patients. The main result of the endoscopy on AIDS patients has therefore been the diagnosis of visceral localisations of Kaposi's sarcoma. The appearance of the secondary major lesions related to opportunistic infections is unusual, especially in asymptomatic patients. A systematic endoscopy on these patients remains a disputed question.
对45例获得性免疫缺陷综合征（AIDS）患者进行了胃肠内镜检查（42例上消化道内镜检查和12例结肠镜检查）。28例患者有皮肤或口腔卡波西肉瘤，伴或不伴有机会性感染，17例有机会性感染。45例患者中有12例（27%）有1处或多处卡波西肉瘤的胃肠道宏观定位，其中12例经上消化道内镜检查证实，4例经结肠镜检查证实。内镜活检在16次中有5次（31%）确诊。16例患者（38%）有念珠菌性食管炎，1例有溃疡性胃窦炎，2例有红斑性十二指肠炎，6例有弥漫性炎症性结肠黏膜改变。组织学记录的特异性异常为1例全绒毛萎缩和2例巨细胞病毒性结肠炎。有皮肤卡波西肉瘤的患者比没有卡波西肉瘤的患者更常出现胃肠道卡波西肉瘤。上消化道内镜检查记录的肿瘤性或主要（弥漫性念珠菌性食管炎、溃疡性胃窦炎、活动性结肠炎）内镜异常在无症状患者中的患病率为40%（25例中有10例），腹泻患者中为43%（7例中有3例），吞咽困难、上腹部疼痛或呕吐患者中为60%（10例中有6例），结肠镜检查记录的在有黏液或血便患者中的患病率为75%（4例中有3例），腹泻患者中为14%（7例中有1例）。因此，对艾滋病患者进行内镜检查的主要结果是诊断卡波西肉瘤的内脏定位。与机会性感染相关的继发性主要病变的表现并不常见，尤其是在无症状患者中。对这些患者进行系统的内镜检查仍然是一个有争议的问题。
