Geographical Pathology of Kaposi's sarcoma and AIDS

卡波西肉瘤（Kaposi's sarcoma，KS）至少可分为以下四种类型：1）经典型，2）非洲地方型，3）艾滋病流行型，4）包括肾移植后型在内的其他类型。对前三种形式的KS进行了病理学研究。在美国，典型KS患者通常是中年或老年人。病变呈扁平状，偶尔呈退行性。赤道非洲的非洲地方病形式具有很大的特点，其临床病程长，结节灶和各种组织学特征，如非特异性炎症，血管瘤性和纤维肉瘤性病变。在所有恶性肿瘤中，非洲地方性KS的频率为2.92%。KS的高发年龄在50 ~ 59岁之间。男女比例为8.4：1.0。热带萨凡纳和热带高原的主要居民中KS的发病率较高，而沙漠和半沙漠地区的居民中未发现KS病例。KS与肯尼亚西部非洲伯基特淋巴瘤的地理分布和民族分布相对一致。AIDS的KS表现为出血性病变和血管瘤样改变。这种形式的患者的年龄主要在20-50岁之间。这些研究结果表明，病因学的辅助因素，包括高温，高湿度，未知的传播媒介，并可能遗传，人类生态和社会经济因素是相当显着的疾病表现KS。

Kaposi's sarcoma (KS) can be classified into at least four fomrs as follows: 1) Classical form, 2) African endemic form, 3) Epidemic form of AIDS and 4) Other forms including post-renal transplantation form. Former three forms of KS were investigated geopathologically. Patients of classical KS in the United States are usually of middle or older ages. The lesions are flat and occasionally regressive. African endemic form in equatorial Africa is quite characteristic by its long duration of clinical course, nodular foci and various histological features such as non specific inflammatory, angiosarcomatous, and fibrosarcomatous lesions. Frequency of African endemic KS in all malignant tumors was 2.92%. The high incidence of KS was found between the age of 50 and 59. The male to female ratio was 8.4:1.0. The high incidence of KS was found among the main inhabitants of tropical savannah and tropical highland, while no case of KS was found among inhabitants of desert or semi-desert areas. KS and African burkitt's lymphoma in western Kenya showed relatively same geographical and ethnical distribution. KS of AIDS shows hemorrhagic lesions and angiomatous features. The age of patients of this form was mainly between 20-50. These findings suggest that etiological cofactors including high temperature, high humidity, unknown transmissible agents, and probably genetic, human ecological, and socioeconomical factors are quite significant on disease manifestations of KS.