Classic Kaposi sarcoma in northern Sardinia: a prospective epidemiologic overview (1977-2003) correlated with malaria prevalence (1934)

Background Studies have demonstrated considerable variations in classic Kaposi sarcoma (CKS) incidence within Europe, with some of the highest incidences found in the Mediterranean area. As a Mediterranean area, northern Sardinia has a high CKS frequency. Objective In order to determine CKS incidence in people born in and residing in northern Sardinia, a clinical prospective epidemiologic study was carried out between 1977 and 2003 by the Department of Dermatology, University of Sassari. We also evaluated a correlation between malaria prevalence in 1934, estimated on the eight historical sub-areas of the Sassari province, and the standardized morbidity ratio from 1977 to 2003. Results A total of 332 patients with CKS were identified. Incidence among the northern Sardinian population ≥40 years of age was 4.06/100,000 persons/year and it was almost stable through the years. The male to female ratio showed a significant decline from 3.6 to 2.5 (P = .03). Females had a statistically decreased risk of developing CKS compared to males (adjusted incidence rate ratio = 0.27; 95% CI: 0.21-0.34), and the risk of developing CKS increased exponentially with age. The prevalence of malaria in each sub-area ranged from 9% to 91%. The standardized morbidity ratio for CKS in the years between 1977 and 2003 ranged from 0.27 to 1.76; the regression coefficient was −0.85 (95% CI: −2.94-1.24), yielding a nonsignificant relationship between the two diseases

Overexpression of the fibroblast growth factor receptor 2-IIIc in Kaposi's sarcoma

Kaposi's sarcoma (KS) is a neoplastic disorder characterized by a highly vascularized lesion with bundles of spindle-shaped cells, pathognomonic of the disease, infiltrated by mononuclear inflammatory and plasma cells. The KS lesion presents as a patch/plaque, which eventually develops into a nodular tumor. Thus far, the mechanisms involved in the etiopathogenesis of KS are not completely understood. Kaposi's Sarcoma-associated Herpesvirus (KSHV) infection is present in all KS cases. However, KSHV is not sufficient for the development of the disease and other factors are certainly involved. Alterations in the expression of cytokines, growth factors and relative receptors have been analyzed over the years. To evaluate the involvement of FGFR2 in the development and progression of KS, we assayed by immunohistochemistry and quantitative real-time PCR (Q-RT-PCR) the expression of FGFR2-IIIb and FGFR2-IIIc in biopsies of KS lesions compared to normal skin. Further studies are needed to analyze whether FGFR2-IIIc up-regulation varies in the history of the disease, and whether these variations might correlate with the clinical status of the disorder. In any case, our survey provides new elements to better understand the complex interplay between viral infection and host response in the development of KS