Kaaya E E, Castaños-Velez E, Amir H, Lema L, Luande J, Kitinya J, Patarroyo M, Biberfeld P
Department of Pathology, Karolinska Hospital/Institute, Stockholm, Sweden.
Histopathology. 1996 Oct;29(4):337-46. doi: 10.1111/j.1365-2559.1996.tb01417.x.
Spindle cells and vascular endothelium in nodular lesions of AIDS associated (epidemic) and endemic Kaposi's sarcoma showed similar immunohistochemical patterns of expression for cell adhesion molecules and extracellular matrix proteins. Spindle cells as well as endothelium also expressed both alpha 5 and alpha V integrin subunits and ICAM-1 suggesting a possible role for inflammatory cytokines in spindle cell formation. The spindle cell compartment was rich in collagen, laminin, fibronectin and tenascin suggesting an important reactive component in the evolution of Kaposi's sarcoma. The lack of thrombospondin expression in the spindle cells favours the contention that they could be transitional, proliferating cells of endothelial origin. Specific expression of tat protein was not seen suggesting minimal if any HIV replication in these lesions. Our findings suggest similar histopathogenetic mechanisms for endemic and epidemic Kaposi's sarcoma. The clinically more malignant features of most AIDS related cases may reflect an important effect of systemic and focal cytokines in HIV patients and possibly other cofactor(s), i.e. tat protein in the induction and growth of the lesions.
在艾滋病相关（流行性）和地方性卡波西肉瘤的结节性病变中，梭形细胞和血管内皮细胞在细胞黏附分子和细胞外基质蛋白的表达上呈现出相似的免疫组化模式。梭形细胞以及内皮细胞还表达α5和αV整合素亚基以及细胞间黏附分子-1（ICAM-1），这表明炎性细胞因子在梭形细胞形成中可能发挥作用。梭形细胞区富含胶原蛋白、层粘连蛋白、纤连蛋白和腱生蛋白，这表明在卡波西肉瘤的演变过程中存在一个重要的反应性成分。梭形细胞中缺乏血小板反应蛋白的表达，这支持了它们可能是内皮源性过渡性增殖细胞的观点。未观察到tat蛋白的特异性表达，这表明这些病变中即使有HIV复制也极少。我们的研究结果表明地方性和流行性卡波西肉瘤具有相似的组织病理发生机制。大多数艾滋病相关病例临床上更具恶性的特征可能反映了全身性和局灶性细胞因子对HIV患者以及可能的其他辅助因子（即tat蛋白）在病变诱导和生长中的重要作用。
