Nasti G, Vaccher E, Errante D, Tirelli U
Division of Medical Oncology and AIDS, National Cancer Center, Aviano, Italy.
Biomed Pharmacother. 1997;51(6-7):243-51. doi: 10.1016/S0753-3322(97)83539-1.
One in six patients with acquired immunodeficiency syndrome (AIDS) both in the USA and Europe develop malignancies, in particular Kaposi's sarcoma (KS) and non-Hodgkin's lymphoma (NHL). After an initial rapid increase, the proportion of AIDS patients with KS steadily declined in the USA and in Europe, while the proportion of AIDS-NHL has been stable during the last decade in the USA and Europe. Human immunodeficiency virus (HIV) infected patients are living longer due to advances in antiretroviral therapy and treatment of prophylaxis against opportunistic infections, yet because of their immunodeficiency they are at high risk for cancers, especially NHL. The natural history of cancers in patients with HIV infection differs from that of the general population. Unusual aspects of tumor localization, growth behavior and therapeutical response distinguish tumors in patients with HIV infection from those without. The pathologic and virological aspects of HIV-related tumors are peculiar and a pathological classification of HIV-associated systemic lymphomas based on the morphological features of the two main types, ie, blastic and anaplastic cell lymphomas, has been formulated. The treatment of HIV-related neoplasms is controversial as it is not clear whether conventional therapy, particularly chemotherapy, is able to modify the natural history of these malignancies in the HIV setting. Moreover the treatment of HIV-related tumors presents several problems due to the aggressive behaviors of tumors and because of immunosuppressive chemotherapy employed in patients with immunodeficiency. This paper reviews the most relevant data on the epidemiology, pathology and treatment of malignant tumors in patients with HIV infection.
在美国和欧洲，六分之一的获得性免疫缺陷综合征（艾滋病）患者会发生恶性肿瘤，尤其是卡波西肉瘤（KS）和非霍奇金淋巴瘤（NHL）。在美国和欧洲，艾滋病合并KS患者的比例在最初快速上升后稳步下降，而艾滋病合并NHL患者的比例在过去十年中在美国和欧洲一直保持稳定。由于抗逆转录病毒疗法和机会性感染预防治疗的进展，感染人类免疫缺陷病毒（HIV）的患者寿命延长，但由于免疫缺陷，他们患癌症的风险很高，尤其是NHL。HIV感染患者癌症的自然史与普通人群不同。肿瘤定位、生长行为和治疗反应的异常方面使HIV感染患者的肿瘤与未感染患者的肿瘤有所区别。HIV相关肿瘤的病理和病毒学方面很特殊，并且已经制定了基于两种主要类型（即母细胞性和间变性细胞淋巴瘤）形态特征的HIV相关系统性淋巴瘤的病理分类。HIV相关肿瘤的治疗存在争议，因为尚不清楚传统疗法，尤其是化疗，是否能够改变这些恶性肿瘤在HIV环境中的自然史。此外，由于肿瘤的侵袭性以及免疫缺陷患者使用免疫抑制化疗，HIV相关肿瘤的治疗存在几个问题。本文综述了HIV感染患者恶性肿瘤流行病学、病理学和治疗方面的最相关数据。
