Research On Pathogenesis And Genotypes Of Infected Virus Of Classic Kaposi Sarcoma From Fujian Province

Objective: With the aging of population,the morbidity of classic Kaposi sarcoma in Fujian province is increasing year by year.In order to improve the diagnosis rate and promote effective treatment of this disease,we research on the clinical and pathological features of the classic Kaposi sarcoma from Fujian province,and to identify the HHV-8 genotype of the infection.At the same time,to explore the pathogenesis of the classic Kaposi sarcoma from Fujian province.Contents: To analyze the clinical and pathological features of classic Kaposi sarcoma patients from Fujian province.The genotypes of HHV-8 ORF-K1,T0.7/K12,ORF-K14.1/K15,ORF26 and ORF75 were detected in the classic Kaposi sarcoma patients from Fujian Province,while the pathogenesis was explored.Methods: 1.The clinical data and paraffin-embedded tissue specimens of classic Kaposi's sarcoma diagnosed in the dermatology clinic and ward from 2008 to 2018 were collected and analyzed.2.The QIAamp? DNA FFPE Tissue kit was used to extract viral DNA from the patient's lesion,and different genotypes of HHV-8(ORF-K1,T0.7/K12,ORF-K14.1/K15,Primers of ORF26 and ORF75)were amplified by nested-PCR,and then were bidirectional sequenced.The sequences were confirmed by SnapGene software to determine the expression of HHV-8 genotypes.3.Immunohistochemistry of D2-40,C-kit,VEGF,bFGF and PD-L1 of the paraffin-embedded tissues of classic Kaposi sarcoma were made.Results: 1.24 cases of classic Kaposi sarcoma from Fujian province are more common in men,whose average age of onset was 67.29±19.78 years old.The main site of the disease is located in the lower extremities,especially below the calf.Most patients presented with nodular lesions.All the patients were Han nationality.2.The pathological histology of classic Kaposi sarcoma mainly divided into three stages.(?)Patch stage-vascular hyperplasia and red blood cell extravasation can be seen in the dermis.(?)Plaque stage-a small amount of spindle cells and lake-like ectatic space can be seen in the dermis.(?)Nodule stage-a large number of spindle cells,lake-like ectatic space and mitoses exist in the dermis.Immunohistochemistry showed CD31(+),CD34(+),HHV-8(+),Ki-67(+).3.The expression rate of ORF26 genotype in 24 cases of classic Kaposi sarcoma patients from Fujian Province was 100%,while that of ORF-K1,T0.7/K12,ORF-K14.1/K15 and ORF75 were 0.00%.4.Rooted tree shows that HHV-8 ORF26 is mainly expressed with C subtype.5.The positive rates of immunohistochemical of D2-40,C-kit,VEGF,bFGF and PD-L1 were 100.00%,79.17%,100.00%,100.00% and 0.00%,respectively.Conclusion: 1.The classic Kaposi sarcoma patients from Fujian province are more common in older men.The main sites of the disease are located in the lower extremities,especially below the calves.Nodule is more presented.All the patients were Han nationality.2.The genotypes of HHV-8 infected by cKS patients in Fujian province were mainly ORF26,and all were C subtype.3.Immunohistochemistry showed the positive rate of D2-40,VEGF and bFGF were all 100.00%,C-kit positive rate was 79.17%,suggesting that classic Kaposi Sarcoma is originated in blood vessels and lymphatic vessels,and its pathogenesis may be related to C-kit.