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Volume 4 No. 2, April 2009 |
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Kaposi’s sarcoma: Role of Diagnostic and Prognostic Immunohistochemical Markers Abdel-Ghani A Selim & Omnia MK Rizk
Department of Pathology, Faculty of Medicine, Tanta University,
Egypt
Background/Aim: Kaposi sarcoma, a tumor of uncertain
histogenesis, has long been considered to be caused by a
transmissible infectious agent. Human herpes virus 8 (HHV8) or
Kaposi sarcoma associated herpes virus (KSHV) is generally accepted
to be the most likely candidate agent, and this is supported by its
strong association with all subtypes of Kaposi. On the other hand,
down-regulation of p27Kip1 expression seems to facilitate metastatic
dissemination in a variety of human neoplasms. Although the
neoplastic nature of KS remains controversial, it has been
repeatedly demonstrated that in some patients KS may behave as a
malignant neoplasm and follow an ominous course. The aim of this
study was to differentiate between KS and its mimickers, then to use
prognostic markers and study their relation to progression of KS.
Patients & Methods, this study included nine cases of KS and 12
cases of KS mimickers. These cases were examined by routine staining
with H&E, then they were immunostained for CD31, CD34, HHV-8
LNA-1(Diagnostic markers), Bcl-2, p53, p27Kip1, and Ki-67
(Prognostic markers). Results, the included cases of KS and its
mimickers showed positive expression of the vascular markers CD31
and/or CD34. The nine cases of KS were immunopositive for HHV-8 LNA-
but all the mimickers were negative. An increase in the expression
of p53, bcl-2, Ki-67 was detected in relation with progression of
KS. On the other hand down regulation of p27Kip1 was reported with
the progression of KS. Conclusion positive immunostaining for HHV-8
LNA-1 exhibits high sensitivity and specificity for the diagnosis of
KS and was, thus, useful for distinguishing it from the mimickers.
The use of the prognostic markers was useful in detection the
progression of macular form to tumor form of KS. |
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