Kaposi Sarcoma: Clinical Indices and Diagnosis

摘要

Any type of cancer that originate from the connective tissues are termed Sarcomas. The name Kaposi in relation to Kaposi sarcoma was derived from a Hungarian Dermatologist, Dr. Moritz Kaposi who is the first to describe this kind of tumor. KS is caused by a Herpes virus called HHV-8 or KSHV which is transmitted through unprotected sexual intercourse (higher in MSM), sharing of used needles, blood transfusion and organ transplant. There are five (5) epidemiological types of KS; Classic, Transplant, African, AIDS-related and Non-epidemic gay related. KS is the commonest symptom of an advanced HIV infected patient and its proliferation is faster due to the weakened immune system. Awareness about this sarcoma is poor. This disease is generally diagnosed as brown, red or purple patches/plaguesodules on the skin, mucosal cavity of the GIT, Lungs and the oral cavity. There are also immunohistochemical staining endothelial markers that are used to differentiate KS from other types of sarcomas. CD31 is best used as an endothelial marker for lesions from HIV+ patients. Some other common markers include CD4, LNA-1, BCL-2 and VEGFR-3. Other symptoms of KS are shortness of breath, internal bleeding Anemia and Fatigue. Highly Active Antiretroviral Therapy (HAART) is believed to be the most efficient treatment for AIDS-related KS. Other soothing treatments available are chemotherapy, topical ointments, cryotherapy, photodynamic therapy, laser therapy and a times excisional surgery. There are active clinical trials towards treatment of KS. Some of which are done by combining different doses of HAART regimen with other therapeutic agents. One of the CTs been conducted by the National Cancer Institute in the U.S is the Phase II/Phase I study using Pomalidomide in treating HIV and Non-HIV patients with Kaposi Sarcoma.