Growth patterns,inflammatory cells and prognosis in AIDS-associated Kaposi's sarcoma

AIDS-associated cutaneous Kaposi's sarcomas (KS) in 35 patients were the subject of a histopathological and immunohistochemical study. Histologically, the tumours were classified as granulation-tissue-like (Gr, n=10), angioma-like (A, n=11), angiosarcoma-like (AS, n=9) and as spindle cell type (SP, n=5). There was a distinct relationship between the main growth patterns of KS and the CD4+ peripheral blood lymphocyte (PBL) count. A decrease in numbers of CD4+ PBL was correlated with an increase in the frequency of AS and SP growth patterns. There were no correlations between growth pattern and concentrations of protein S100+, MT1+, CD45+ and MAK387+ tumour-associated inflammatory cells. When the GR type was grouped together with the A type, and the AS type with the SP type, statistically significant differences emerged for CD45+ and MT1+ tumour-associated cells, and for survival time, respectively.In all these instances, the GR/A group values were higher than those of the AS/SP group. Additionally, linear correlation analysis revealed an inverse relationship between the concentrations of CD4+ PBL and of protein S100+ tumour-associated inflammatory cells within the GR/A group. In contrast to what is observed with certain tumours of HIV-negative patients, this suggests that a high concentration of protein S100+ tumour-associated cells may indicate a worse prognosis in the GR/A group. The concentration of MAK387+ tumour-associated macrophages did not vary as a function of the growth patterns, even when they were grouped together as described above. It is concluded that the different types of KS fo not vary in the production of tumour-derived chemotactic factors crucial for monocyte/macrophage migration into the stroma of malignant tumours.