Analysis Of Clinical Features Of Kaposi’s Sarcoma With Single Skin Lesions And Study On The Expression Level Of IKKα In Kaposi’s Sarcoma

Objective:1.To summarize the clinical features of Kaposi’s sarcoma with single lesion as the first manifestation and analyze the causes of misdiagnosis.2.Immunohistochemical techniques are being employed to investigate the expression and importance of IKKα in Kaposi’s sarcoma,thereby affirming NF-κB signaling pathway involvement in the genesis of Kaposi’s sarcoma and providing a novel target for the disease’s treatment.Methods:1.At the People’s Hospital of Xinjiang Uygur Autonomous Region,a clinical analysis of 12 Kaposi’s sarcoma cases,each diagnosed with single lesions as the initial manifestation,was conducted from January 2020 to January 2022.2.From October 2018 to October 2020,the People’s Hospital of Xinjiang Uygur Autonomous Region was the source of 40 Kaposi’s sarcoma cases,40 hemangioma cases,and 30 normal tissue samples.Immunohistochemical method revealed the expression of IKKα in the three tissues.Results:1.Out of the 12 instances,10 were of the male gender and 2 were female.Nine cases were Uygur and three Kazakh.The age of onset was 20-76 years old,with an average of(59.8±14.2)years old and 10 cases ≥60 years old.In 8instances,the foot was the most frequent site,with 3 occurrences at the lateral side,2 at the base,1 at the ankle,1 at the back of the third toe,and 1 between the third and fourth toes.The other cases were fibular side of right calf(2 cases),dorsal side of right tongue(1 case)and dorsal fifth finger(1 case)of right hand.The lesions showed dark red nodules in 9 cases,purplish red nodules in 2 cases and purplish red plaques in 1 case.There were 6 cases with pain,1 case with pruritus and 5 cases without symptoms.Among the nodules as lesions,6 cases were first misdiagnosed as skin infection,2 cases as hemangioma,2 cases as squamous carcinoma,and 1 case as fibroma.The first misdiagnosis was psoriasis in 1 case of plaque lesions;The first diagnosis was dermatology in 8 cases,burn in 3 cases and maxillofacial surgery in 1 case.2.IKKα was expressed in three kinds of tissues to varying degrees.In Kaposi’s sarcoma,Ikkα had a positive rate of 80%(32/40)while hemangioma had 75%(30/40)and normal tissues had6.7%(2/30)respectively.No noteworthy divergence in the expression of IKKα was observed between Kaposi’s sarcoma and hemangioma tissues(P > 0.05);however,a statistically significant disparity between the two groups and normal tissues was observed(P<0.05).The expression of IKKα was more positive than in normal tissues.A positive correlation of 0.425(P<0.05)was observed between the expression level of IKKα in Kaposi’s sarcoma and clinical stage,yet no meaningful association was found with sex,nationality,KSHV antibody level,HIV antibody level,or skin lesion area.Conclusions:1.The 12 cases of Kaposi’s sarcoma were more common in men over 60 years old,and the most common cases were Uygur nationality,followed by Kazak nationality.Most lesions occur on the foot,especially the lateral edge of the foot.The rash was mainly purplish red nodules,and half of the patients were accompanied by pain.2.Single lesions are rare in Kaposi’s sarcoma with atypical manifestations and easy to be misdiagnosed clinically.In this study,skin infection was more common in misdiagnosed diseases,and33.3 %(4/12)of patients came from professional outpatient departments other than dermatology.The expression of IKKα in Kaposi’s sarcoma was studied by immunohistochemistry.It was found that IKKα was expressed in Kaposi’s sarcoma to varying degrees,and was positively correlated with the clinical stage of the disease,suggesting that IKKα may play an important role in the development of Kaposi’s sarcoma.