新疆地区胃肠道卡波西肉瘤活检62例临床与病理分析

Gastrointestinal Kaposi’s sarcoma:a clinicopathological analysis of 62 biopisy cases in Xinjiang

目的探讨胃肠道卡波西肉瘤的临床及病理学特点。方法回顾性分析62例胃肠道卡波西肉瘤活检患者的临床资料,结合组织形态学、免疫组化结果,分析其临床病理特征。结果62例病例中,男性46例,女性16例,发病年龄6~67岁,平均年龄42岁。经实验室检测,其中56例呈HIV阳性(90.3%),6例为HIV阴性(9.7%)。胃肠道卡波西肉瘤形态学以梭形细胞增生、血管瘤样结构、红细胞外溢、含铁血黄素沉积及慢性炎细胞浸润为主。所有病例均未见肿瘤性坏死。免疫组化CD31、CD34、HHV-8阳性率均为100%,Fli-1阳性率为97.9%,SMA、CD117和S-100阳性率分别为22.0%、29.8%和5.8%,Ki-67增殖指数为1%~20%不等。结论胃肠道卡波西肉瘤的活检诊断存在一定难度,需对疑似病例常规进行内镜筛查,并加做免疫组化标记以提高疾病的检出率。

Objective To investigate the clinical and pathological features of gastrointestinal Kaposi’s sarcoma in biopisy cases.Methods Histopathological characteristics and immuoistochemical markers were studied retrospectively,and the clinicopathologic features were analyzed.Results Among the 62 cases,46 were males and 16 were females;the age of onset was 6-67 years,with average age of 42 years.Through laboratory testing,a total of 56(90.3%)were HIV positive,and 6(9.7%)were HIV negative.The morphology of Kaposi’s sarcoma in gastrointestinal tract was characterized by spindle cell hyperplasia,hemangioma-like structure,red blood cell efflux,hemosiderin deposition and chronic inflammatory cell infiltration.There was no necrosis in all cases.The expression of CD31,CD34 and HHV-8 was 100%,HHV-8 was weak expression in 2 cases,and the expression of Fli-1 was 97.9%.SMA and CD117 were expressed in 22%and 29.8%cases,repectively;S-100 was positive in 5.8%cases,Ki-67 proliferation index was 1%-20%.Conclusion It may be difficult to diagnose Kaposi’s sarcoma of gastrointestinal tract by biopsy,and so it is necessary to screen the suspected cases by endoscopy and to add immunohistochemical markers to improve the detection rate of the disease.