Immunohistochemical detection of Bcl-2 in Kaposi's sarcoma lesions varies according to histopathologic stage, whereas expression of Bcl-x and Mcl-1 differs according to human immunodeficiency virus serologic status of patients.

Expression of Bcl-2, Bcl-x, and Mcl-1 was immunohistochemically evaluated in 33 cases of Kaposi's sarcoma (KS) of the skin. Of these, classic KS (C-KS) accounted for 17 cases (10 in plaque stage and 7 in tumor stage) and acquired immunodeficiency syndrome-associated KS (AIDS-KS) accounted for 16 cases (8 in plaque stage and 8 in tumor stage). In both C-KS and AIDS-KS, Bcl-2 immunoreaction correlated with progression stage, its average score intensity being more than 2-fold in tumors than in plaques. In contrast, Bcl-x and Mcl-1 staining intensity was unrelated to progression stage but was dependent on human immunodeficiency virus infection status. Thus, whereas Bcl-x expression was stronger in C-KS cases, Mcl-1 immunostaining was more intense in AIDS-KS instances. These findings indicate that in cutaneous KS, some Bcl-2 family proteins exhibit differential expressions that are dependent on either progression stage or human immunodeficiency virus infection status.