101
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Aydin AM, Hall M, Bunch BL, Branthoover H, Sannasardo Z, Mackay A, Beatty M, Sarnaik AA, Mullinax JE, Spiess PE, Pilon-Thomas S. Expansion of tumor-infiltrating lymphocytes (TIL) from penile cancer patients. Int Immunopharmacol 2021; 94:107481. [PMID: 33636562 DOI: 10.1016/j.intimp.2021.107481] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 02/02/2021] [Accepted: 02/04/2021] [Indexed: 12/31/2022]
Abstract
Penile cancer is a rare but highly lethal cancer, and therapeutic options for patients presenting with lymph nodal disease are very limited. Adoptive cell therapy (ACT) using tumor-infiltrating lymphocytes (TIL) was shown to provide durable objective response in patients with metastatic melanoma and TIL have been expanded from solid tumors at rates between 70 and 90% depending on the specific diagnosis. We evaluated whether TIL could be expanded from surgical specimens of patients with penile cancer. Tumor samples from metastatic lymph nodes obtained at the time of inguinal lymph node dissection were collected, minced into fragments, placed in individual wells of a 24-well plate, and propagated in high dose IL-2 for four weeks. The phenotype of expanded TILs was assessed by flow cytometry and their anti-tumor reactivity was assessed by IFN-γ ELISA. TIL were expanded from 11 out of 12 (91.6%) samples of metastatic lymph nodes. Expanded TIL were predominantly CD3+ (mean 67.5%, SD 19.4%) with a mean of 46.8% CD8+ T cells (SD 21.1%). Five out of 11 samples (45.4%) from expanded TIL secreted IFN-γ in response to autologous tumor. TIL expansion and phenotype of expanded T cell lymphocytes were independent of previous HPV infection and treatment with neoadjuvant chemotherapy. This is the first report demonstrating successful expansion of tumor-reactive TIL from penile cancer patients, which support development of ACT strategies using TIL for the treatment of advanced and recurrent penile cancer.
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Affiliation(s)
- Ahmet Murat Aydin
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - MacLean Hall
- Department of Immunology, Moffitt Cancer Center, Tampa, FL, USA; Cancer Biology PhD Program, University of South Florida, Tampa, FL, USA
| | | | | | | | - Amy Mackay
- Department of Immunology, Moffitt Cancer Center, Tampa, FL, USA
| | - Matthew Beatty
- Department of Immunology, Moffitt Cancer Center, Tampa, FL, USA
| | - Amod A Sarnaik
- Department of Immunology, Moffitt Cancer Center, Tampa, FL, USA; Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - John E Mullinax
- Department of Immunology, Moffitt Cancer Center, Tampa, FL, USA; Sarcoma Program, Moffitt Cancer Center, Tampa, FL, USA
| | - Philippe E Spiess
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Shari Pilon-Thomas
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL, USA; Department of Immunology, Moffitt Cancer Center, Tampa, FL, USA; Center for Immunization and Infection Research in Cancer (CIIRC), Moffitt Cancer Center, Tampa, FL, USA.
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102
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Shim TN, Harwood CA, Marsh SG, Gotch FM, Quint W, de Koning MN, Francis N, Jameson C, Freeman A, Minhas S, Muneer A, Dinneen M, Bunker CB. The prevalence of human leucocyte antigen and human papillomavirus DNA in penile intraepithelial neoplasia in England 2011-2012. Int J STD AIDS 2021; 32:388-395. [PMID: 33576716 DOI: 10.1177/0956462420970727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The pathogenesis of penile intraepithelial neoplasia (PeIN) is unclear but human papillomavirus (HPV) infection and polymorphisms in human leucocyte antigen (HLA). OBJECTIVES To examine the prevalence of HPV DNA and HLA in PeIN. METHODS Adult Caucasian men with a clinical and histological diagnosis of PeIN, that is, Bowenoid papulosis (BP), Bowen's disease of penis (BDP) and erythroplasia of Queyrat (EQ) were selected and phenotyped from the clinical records. DNA was extracted from blood and paraffin-embedded sections for HLA and HPV typing, respectively. Human leucocyte antigen allele frequencies were compared with those derived from the UK-based Caucasian population. RESULTS Seventy-two cases of PeIN (20 BP, 34 BDP and 18 EQ) were studied. Human papillomavirus DNA was identified in 65/72 (90.2%) PeIN; Alphapapillomavirus types were detected in 62/72 (85%) followed by Betapapillomavirus types in 9/72 (12.5%) and cutaneous types in 7/72 (9.7%); HPV16 was the most prevalent genotype at 35/72 (48.6%) followed by HPV33 at 7/72 (9.7%); multiple infections were seen in 18/72 (25%) PeIN. HLA-C*15 (Bonferroni corrected p = 0.049) confers susceptibility to PeIN, whereas HLA-DQA1*01 (corrected p = 0.02) protects against PeIN. HPV16-associated PeIN cases showed no statistically significant association with HLA genotype after multiple corrections. CONCLUSION Human papillomavirus is involved in the pathogenesis of PeIN. Immunogenotype may play a role in the pathogenesis of PeIN.
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Affiliation(s)
- Tang Ngee Shim
- Dermatology Department, University College Hospital, Chelsea and Westminster Hospital, London, UK
| | - Catherine A Harwood
- Center for Cutaneous Research and Cell Biology, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Steven Ge Marsh
- Anthony Nolan Research Institute and University College London Cancer Institute, London, UK
| | | | - Wim Quint
- DDL Diagnostic Laboratory, Rijswijk, Netherlands
| | | | - Nick Francis
- Pathology Department, Imperial College Healthcare NHS Trust, London, UK
| | - Charles Jameson
- Pathology Department, 4919University College London Hospital, London, UK
| | - Alex Freeman
- Pathology Department, 4919University College London Hospital, London, UK
| | - Suks Minhas
- Andrology Centre and the Institute of Urology, 4919University College London Hospital, London, UK
| | - Asif Muneer
- Andrology Centre and the Institute of Urology, 4919University College London Hospital, London, UK
| | - Michael Dinneen
- Urology Department, Chelsea and Westminster Hospital, London, UK
| | - Christopher B Bunker
- Dermatology Department, University College Hospital, Chelsea and Westminster Hospital, London, UK
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103
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Thomas A, Necchi A, Muneer A, Tobias-Machado M, Tran ATH, Van Rompuy AS, Spiess PE, Albersen M. Penile cancer. Nat Rev Dis Primers 2021; 7:11. [PMID: 33574340 DOI: 10.1038/s41572-021-00246-5] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/12/2021] [Indexed: 12/27/2022]
Abstract
Penile squamous cell carcinoma (PSCC) is a rare cancer with orphan disease designation and a prevalence of 0.1-1 per 100,000 men in high-income countries, but it constitutes up to 10% of malignancies in men in some African, Asian and South American regions. Risk factors for PSCC include the absence of childhood circumcision, phimosis, chronic inflammation, poor penile hygiene, smoking, immunosuppression and infection with human papillomavirus (HPV). Several different subtypes of HPV-related and non-HPV-related penile cancers have been described, which also have different prognostic profiles. Localized disease can be effectively managed by topical therapy, surgery or radiotherapy. As PSCC is characterized by early lymphatic spread and imaging is inadequate for the detection of micrometastatic disease, correct and upfront surgical staging of the inguinal lymph nodes is crucial in disease management. Advanced stages of disease require multimodal management. Optimal sequencing of treatments and patient selection are still being investigated. Cisplatin-based chemotherapy regimens are the mainstay of systemic therapy for advanced PSCC, but they have poor and non-durable responses and high rates of toxic effects, indicating a need for the development of more effective and less toxic therapeutic options. Localized and advanced penile cancers and their treatment have profound physical and psychosexual effects on the quality of life of patients and survivors by altering sexual and urinary function and causing lymphoedema.
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Affiliation(s)
- Anita Thomas
- Laboratory of Experimental Urology, Department of Development and Regeneration, KU Leuven, Leuven, Belgium.,Department of Urology, University Hospitals Leuven, Leuven, Belgium.,Department of Urology and Pediatric Urology, University Medical Center Mainz, Mainz, Germany
| | - Andrea Necchi
- Genitourinary Medical Oncology, IRCCS San Raffaele Hospital and Scientific Institute, Milan, Italy
| | - Asif Muneer
- Department of Urology, University College London Hospitals, London, UK.,National Institute for Health Research (NIHR) Biomedical Research Centre, University College London Hospitals, London, UK.,Division of Surgery and Interventional Science, University College London, London, UK
| | - Marcos Tobias-Machado
- Section of Urologic Oncology, Department of Urology, ABC Medical School, Instituto do Cancer Vieira de Carvalho, São Paulo, Brazil
| | - Anna Thi Huyen Tran
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | | | - Philippe E Spiess
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Maarten Albersen
- Laboratory of Experimental Urology, Department of Development and Regeneration, KU Leuven, Leuven, Belgium. .,Department of Urology, University Hospitals Leuven, Leuven, Belgium.
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104
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Farahmand M, Monavari SH, Tavakoli A. Prevalence and genotype distribution of human papillomavirus infection in different anatomical sites among men who have sex with men: A systematic review and meta-analysis. Rev Med Virol 2021; 31:e2219. [PMID: 33527636 DOI: 10.1002/rmv.2219] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 01/07/2021] [Accepted: 01/12/2021] [Indexed: 12/15/2022]
Abstract
Men who have sex with men (MSM) are at increased risk of human papillomavirus (HPV) infection because of their high-risk sexual behaviours. In this study, a meta-analytic approach was used to systematically analyse the literature to elucidate the prevalence and genotype distribution of anal, penile, oral and urethral HPV infection among MSM in the world. To carry out this systematic review, five electronic databases including Web of Science, PubMed, Scopus, Embase, and Google Scholar were searched for relevant studies published from January 2012 to November 2019, and pertinent data were collected from the eligible articles. The pooled HPV prevalence was calculated for each anatomical region using a random-effect model weighted by the inverse variance method. The meta-analysis was performed using the "Metaprop" function in the R package Meta. The overall pooled prevalence of anal, penile, oral and urethral HPV infection among MSM were 78.4% (95% confidence interval [CI]: 75.6%-81.0%), 36.2% (95% CI: 29.1%-44.0%), 17.3% (95% CI: 13.6%-21.7%) and 15.4% (95% CI: 7.8%-27.9%), respectively. Stratified analyses showed that the prevalences of HPV were significantly higher in HIV-positive than HIV-negative MSM. The most frequent HPV high-risk type detected in the anus, penis and oral cavity was HPV-16 (19.9%, 4.9% and 3.1%, respectively). HPV infection is rising in MSM because of high-risk sexual behaviours, suggesting an increased future risk of developing HPV-related diseases and malignancies in this population.
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Affiliation(s)
- Mohammad Farahmand
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Hamidreza Monavari
- Department of Medical Virology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Tavakoli
- Department of Medical Virology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.,Research Center of Pediatric Infectious Diseases, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
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105
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Medeiros-Fonseca B, Cubilla A, Brito H, Martins T, Medeiros R, Oliveira P, Gil da Costa RM. Experimental Models for Studying HPV-Positive and HPV-Negative Penile Cancer: New Tools for An Old Disease. Cancers (Basel) 2021; 13:cancers13030460. [PMID: 33530343 PMCID: PMC7865362 DOI: 10.3390/cancers13030460] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/11/2021] [Accepted: 01/23/2021] [Indexed: 12/28/2022] Open
Abstract
Simple Summary Penile cancer is an uncommon and understudied malignancy that is most commonly diagnosed in developing countries. Therapeutic advances have been slow, in part due to the lack of in vitro and in vivo models for testing new drugs before performing clinical trials. Recently, this difficulty has been partly overcome and multiple new pre-clinical models were reported. These important developments will help develop new therapies for penile cancer patients. The present review summarizes and discusses the available data concerning the pre-clinical models of penile cancer and their uses. Comparisons are drawn between different models, allowing researchers to choose the most adequate setting for their experiments. The remaining gaps in this array of penile cancer models are also discussed, in particular the lack of models for studying metastatic disease and cell lines representing tumors associated with human papillomavirus. Abstract Penile cancer is an uncommon malignancy that occurs most frequently in developing countries. Two pathways for penile carcinogenesis are currently recognized: one driven by human papillomavirus (HPV) infection and another HPV-independent route, associated with chronic inflammation. Progress on the clinical management of this disease has been slow, partly due to the lack of preclinical models for translational research. However, exciting recent developments are changing this landscape, with new in vitro and in vivo models becoming available. These include mouse models for HPV+ and HPV− penile cancer and multiple cell lines representing HPV− lesions. The present review addresses these new advances, summarizing available models, comparing their characteristics and potential uses and discussing areas that require further improvement. Recent breakthroughs achieved using these models are also discussed, particularly those developments pertaining to HPV-driven cancer. Two key aspects that still require improvement are the establishment of cell lines that can represent HPV+ penile carcinomas and the development of mouse models to study metastatic disease. Overall, the growing array of in vitro and in vivo models for penile cancer provides new and useful tools for researchers in the field and is expected to accelerate pre-clinical research on this disease.
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Affiliation(s)
- Beatriz Medeiros-Fonseca
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, UTAD, 5001-801 Vila Real, Portugal; (B.M.-F.); (T.M.); (P.O.)
| | - Antonio Cubilla
- Instituto de Patología e Investigación and Universidad Nacional de Asunción, Asunción, Paraguay;
| | - Haissa Brito
- Maranhão Tumour and DNA Biobank (BTMA), Post-graduate Programme in Adult Health (PPGSAD), Federal University of Maranhão (UFMA), São Luís 65080-805, Brazil;
| | - Tânia Martins
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, UTAD, 5001-801 Vila Real, Portugal; (B.M.-F.); (T.M.); (P.O.)
- Veterinary Sciences Department, University of Trás-os-Montes and Alto Douro, UTAD, 5000-801 Vila Real, Portugal
| | - Rui Medeiros
- Molecular Oncology and Viral Pathology Group, CI-IPOP, IPO-Porto, 4200-072 Porto, Portugal;
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Virology Service, IPO-Porto, 4200-072 Porto, Portugal
- Biomedicine Research Center (CEBIMED), Faculty of Health Sciences, Fernando Pessoa University, 4249-004 Porto, Portugal
| | - Paula Oliveira
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, UTAD, 5001-801 Vila Real, Portugal; (B.M.-F.); (T.M.); (P.O.)
- Veterinary Sciences Department, University of Trás-os-Montes and Alto Douro, UTAD, 5000-801 Vila Real, Portugal
| | - Rui M. Gil da Costa
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, UTAD, 5001-801 Vila Real, Portugal; (B.M.-F.); (T.M.); (P.O.)
- Maranhão Tumour and DNA Biobank (BTMA), Post-graduate Programme in Adult Health (PPGSAD), Federal University of Maranhão (UFMA), São Luís 65080-805, Brazil;
- Molecular Oncology and Viral Pathology Group, CI-IPOP, IPO-Porto, 4200-072 Porto, Portugal;
- Laboratory for Process Engineering, Environment, Biotechnology and Energy (LEPABE), Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal
- Correspondence: ; Tel.: +55-9132728000
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106
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Chahoud J, Gleber-Netto FO, McCormick BZ, Rao P, Lu X, Guo M, Morgan MB, Chu RA, Martinez-Ferrer M, Eterovic AK, Pickering CR, Pettaway CA. Whole-exome Sequencing in Penile Squamous Cell Carcinoma Uncovers Novel Prognostic Categorization and Drug Targets Similar to Head and Neck Squamous Cell Carcinoma. Clin Cancer Res 2021; 27:2560-2570. [PMID: 33441293 DOI: 10.1158/1078-0432.ccr-20-4004] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 12/08/2020] [Accepted: 01/06/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE Penile squamous cell carcinoma (PSCC) is rare with limited treatment options. We report the first whole-exome sequencing (WES) analysis and compare the molecular landscape of PSCC with other squamous cell carcinomas (SCC), with the goal to identify common novel targets. EXPERIMENTAL DESIGN PSCC and matched normal penile tissues from 34 prospectively followed patients, underwent genomic WES and human papilloma virus testing. We performed tumor mutation signature estimation by two methods, first to identify APOBEC-related mutation enrichments and second to classify PSCC-enriched mutational patterns based on their association with the Catalogue of Somatic Mutations in Cancer mutation signatures. We performed an extensive genomic comparison between our PSCC cohort and other SCCs in The Cancer Genome Atlas studies. RESULTS We identified that most PSCC samples showed enrichment for Notch pathway (n = 24, 70.6%) alterations, comparable with head and neck squamous cell carcinoma (HNSC). PSCC mutation signatures are most comparable with HNSC signatures. PSCC samples showed an enrichment of two distinct mutational signatures, the first, associated with oncogenic activity of AID/APOBEC, and the second, associated with defective DNA mismatch repair and microsatellite instability. MP1 enrichment was positively correlated with increased tumor mutation burden (TMB; CC, 0.71; P < 0.0001) and correlated with significantly worse survival in comparison with those with the MP2 subset [HR, 10.2 (1.13-92.9); P = 0.039]. We show that a subset of PSCC (38%), with enrichment of APOBEC-related mutation signature, had significantly higher TMB and worse overall survival in comparison with non-APOBEC-enriched subset [HR, 2.41 (1.11-6.77); P = 0.042]. CONCLUSIONS This study identified novel druggable targets and similarities in mutational signatures between PSCC and HNSC with potential clinical implications.See related commentary by McGregor and Sonpavde, p. 2375.
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Affiliation(s)
- Jad Chahoud
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | | | | | - Priya Rao
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Xin Lu
- The University of Notre Dame, Notre Dame, Indiana
| | - Ming Guo
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Randy A Chu
- The University of Texas MD Anderson Cancer Center, Houston, Texas
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107
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Coba G, Patel T. Penile Cancer: Managing Sexual Dysfunction and Improving Quality of Life After Therapy. Curr Urol Rep 2021; 22:8. [PMID: 33420966 DOI: 10.1007/s11934-020-01022-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE OF REVIEW To review the most current literature on how the treatment for penile cancer can affect quality of life and to discuss current treatment options to overcome sexual dysfunction and ultimately improve patient wellbeing. RECENT FINDINGS Multiple medical and surgical therapies exist to address the high incidence of sexual dysfunction following penile cancer treatment. Advancements and refinements in the neophalloplasty, penile prosthesis, and penile lengthening procedures have opened the door to improved long-term outcomes. Additionally, studies continue to highlight the severe psychological toll that penile cancer treatment can have on patients. We explore the potential options for addressing the inherent psychologic effects of these treatments and highlight the need for further research in this domain. Although rare, it is important for all urologists to be familiar with the treatments and post-treatment sequelae of penile cancer. Penile cancer is associated with dramatic decline in quality of life and sexual function. Multiple medical and surgical therapies exist that addresses these concerns. Additionally, urologists must also be mindful of the psychologic component regarding surgical disfigurement and the decline in sexual function.
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Affiliation(s)
- George Coba
- University of South Florida-Morsani College of Medicine, 12901 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Trushar Patel
- Department of Urology, University of South Florida Morsani College of Medicine, 2 Tampa General Circle, STC6, Tampa, FL, 33606, USA.
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108
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Raison N, Minhas S. Radiosensitisation of Squamous Cell Carcinoma of the Penis in Men Who Are Positive for Human Papillomavirus Infection. Eur Urol Oncol 2020; 4:811-812. [PMID: 33358392 DOI: 10.1016/j.euo.2020.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 12/08/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Nicholas Raison
- Imperial Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - Suks Minhas
- Imperial Andrology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK.
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109
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Chahoud J, Skelton WP, Spiess PE, Walko C, Dhillon J, Gage KL, Johnstone PAS, Jain RK. Case Report: Two Cases of Chemotherapy Refractory Metastatic Penile Squamous Cell Carcinoma With Extreme Durable Response to Pembrolizumab. Front Oncol 2020; 10:615298. [PMID: 33425770 PMCID: PMC7793656 DOI: 10.3389/fonc.2020.615298] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 11/17/2020] [Indexed: 01/17/2023] Open
Abstract
Background Penile squamous cell carcinoma (PSCC) is a rare malignancy, and those patients with metastatic disease have limited treatment options. Treatment is largely comprised of platinum-based chemotherapy; however, patients progressing after initial chemotherapy have a median overall survival (OS) of less than 6 months. Based on a high percentage of PD-L1 expression in patients with PSCC, and its biological similarities to other squamous cell carcinomas, we present two patient cases treated with pembrolizumab with extraordinary durable treatment response far beyond treatment with standard therapy. Main Body The first patient is a 64 year old male with PSCC who was treated with neoadjuvant chemotherapy, partial penectomy, and adjuvant radiation prior to developing metastatic disease. He had a high TMB (14 mutations/Mb) and was started on pembrolizumab with a complete response, which has been maintained for 38 months. The second patient is an 85 year old male with PSCC who was treated with partial penectomy and adjuvant chemotherapy and radiation prior to developing metastatic disease. He had positive PD-L1 expression CPS 130) and was started on pembrolizumab with a partial response, which has been maintained for 18 months after starting treatment. Conclusions These two cases of extreme durable response with pembrolizumab (with molecular data including TMB and PD-L1 status) represent a significant clinical benefit in this patient population. With limited treatment options that result in a median OS of less than 6 months, along with the toxicity profile of chemotherapy which may not be tolerated in elderly patients with comorbidities, this survival benefit with pembrolizumab, along with advances in tumor sequencing and clinical trials shows that there is a potentially significant benefit with novel therapies in this patient population.
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Affiliation(s)
- Jad Chahoud
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, Tampa, FL, United States
| | - William Paul Skelton
- Division of Medical Oncology, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, Tampa, FL, United States
| | - Philippe E Spiess
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, Tampa, FL, United States
| | - Christine Walko
- Division of Individualized Cancer Management, Personalized Medicine, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, Tampa, FL, United States
| | - Jasreman Dhillon
- Department of Anatomic Pathology, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, Tampa, FL, United States
| | - Kenneth L Gage
- Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, Tampa, FL, United States
| | - Peter A S Johnstone
- Departments of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, Tampa, FL, United States
| | - Rohit K Jain
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, Tampa, FL, United States
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110
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Jakobsen JK, Grønkaer Toft B, Predbjørn Krarup K, Høyer S, Bjerggaard Jensen J. Human papilloma virus prevalence in penile cancer: A multicenter study from Denmark (DaPeCa-6). Int J Urol 2020; 28:466-468. [PMID: 33341992 DOI: 10.1111/iju.14474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - Birgitte Grønkaer Toft
- Departments of, Department of, Pathology, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Søren Høyer
- Department of Pathology, Aarhus University Hospital, Aarhus N, Denmark
| | - Jørgen Bjerggaard Jensen
- Department of Urology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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111
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Wieland U, Kreuter A. [Prevention of HPV-induced diseases by prophylactic vaccination]. DER HAUTARZT 2020; 72:106-113. [PMID: 33337514 DOI: 10.1007/s00105-020-04739-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/26/2020] [Indexed: 11/29/2022]
Abstract
Human papillomavirus (HPV) infections belong to the most frequent viral infections. Besides benign common warts and benign and malignant lesions of the head and neck area, HPV can induce anogenital dysplasias and cancers. Since the year 2007, effective and safe prophylactic HPV vaccines are licensed in Europe. To date, a bivalent (HPV16 and 18) and a nonavalent HPV vaccine (HPV6, 11, 16, 18, 31, 33, 45, 52, and 58) are commercially available in Germany. The German standing committee on vaccination (STIKO) currently recommends gender-neutral prophylactic HPV-vaccination between 9 and 14 years of age, with the possibility of catch-up vaccination until the age of 17 years. Besides a large proportion of HPV-induced anogenital dysplasias and carcinomas, the nonavalent HPV vaccine also prevents anogenital warts. Iatrogenically immunocompromised patients older than 17 years of age should also receive prophylactic HPV vaccination, preferrably by the age of 26 years. In case of already acquired HPV infection or existing HPV-induced lesions prophylactic vaccination does not lead to accelerated HPV elimination or clearance of lesions.
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Affiliation(s)
- Ulrike Wieland
- Institut für Virologie, Nationales Referenzzentrum für Papillom- und Polyomaviren, Universitätsklinikum Köln, Universität zu Köln, Köln, Deutschland
| | - Alexander Kreuter
- Klinik für Dermatologie, Venerologie und Allergologie, HELIOS St. Elisabeth Klinik Oberhausen, Universität Witten/Herdecke, Josefstr. 3, 46045, Oberhausen, Deutschland.
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112
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Cuschieri K, Pan J, O Donnell M, Kirkwood K, Kavanagh K, Pollock KG, Bhatia R, Graham SV, Wakeham K. Penile cancer and the HPV attributable fraction in Scotland; A retrospective cohort study. J Clin Virol 2020; 134:104717. [PMID: 33360857 DOI: 10.1016/j.jcv.2020.104717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 12/07/2020] [Accepted: 12/09/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Penile cancer (PeC) is a highly morbid disease which is rising in certain settings including Scotland. A component of PeC is associated with Human Papillomavirus (HPV) although its influence on clinical outcomes is debatable as is whether the fraction attributable to HPV is increasing. METHODS A total of 122 archived tissue samples derived from patients diagnosed with PeC between 2006-2015 were collated and tested for HPV DNA using molecular PCR. HPV positivity was determined for the overall population and by calendar year of diagnosis to determine any temporal trends. The influence of age, deprivation, smoking, tumour stage and tumour grade on likelihood of HPV positivity was determined by logistic regression. In addition, the influence of HPV status and the other clinical and demographics variables on all-cause death and death from PeC was assessed. RESULTS HPV was detected in 43 % (95 % CI: 34-52) of penile cancers and the majority of infections were HPV 16. The HPV component of PeC did not increase over the time period (p for linear trend - 0.226). No demographic or clinical variables were associated with HPV positivity neither was HPV status associated with improved all-cause or cancer-specific survival during the follow up period. CONCLUSION The rise in PeC in Scotland may not be attributable to a rise in HPV-associated cancer; this is consistent with oropharyngeal cancer (OPC) in the UK where there is an increase in both HPV positive and negative cancer. This work calls for a larger multi centre study to enable further detailed investigation into the implications of HPV infection in PeC.
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Affiliation(s)
- K Cuschieri
- Scottish HPV Reference Laboratory, Royal Infirmary of Edinburgh, EH16 4SA, Scotland, United Kingdom; HPV Research Group, Queens Medical Research Institute, University of Edinburgh, EH16 4TJ, Scotland, United Kingdom.
| | - J Pan
- Department of Mathematics and Statistics, Strathclyde University, 26 Richmond Street, Glasgow, G1 1XH, Scotland, United Kingdom
| | - M O Donnell
- Department of Pathology, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, United Kingdom
| | - K Kirkwood
- Department of Pathology, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, United Kingdom
| | - K Kavanagh
- Department of Mathematics and Statistics, Strathclyde University, 26 Richmond Street, Glasgow, G1 1XH, Scotland, United Kingdom
| | - K G Pollock
- School of Health and Life Sciences, Glasgow Caledonian University, G4 6OA, Scotland, United Kingdom
| | - R Bhatia
- Scottish HPV Reference Laboratory, Royal Infirmary of Edinburgh, EH16 4SA, Scotland, United Kingdom; HPV Research Group, Queens Medical Research Institute, University of Edinburgh, EH16 4TJ, Scotland, United Kingdom
| | - S V Graham
- MRC-University of Glasgow Centre for Virus Research, Institute of Infection Immunity and Inflammation, University of Glasgow, G61 1QH, Scotland, United Kingdom
| | - K Wakeham
- MRC-University of Glasgow Centre for Virus Research, Institute of Infection Immunity and Inflammation, University of Glasgow, G61 1QH, Scotland, United Kingdom; Sussex Cancer Centre, Brighton and Sussex University Hospital NHS Trust, 2 Bristol Gate, Brighton, BN2 5BD, United Kingdom
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113
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Bernhard MC, Zwick A, Mohr T, Gasparoni G, Khalmurzaev O, Matveev VB, Loertzer P, Pryalukhin A, Hartmann A, Geppert CI, Loertzer H, Wunderlich H, Naumann CM, Kalthoff H, Junker K, Smola S, Lohse S. The HPV and p63 Status in Penile Cancer Are Linked with the Infiltration and Therapeutic Availability of Neutrophils. Mol Cancer Ther 2020; 20:423-437. [PMID: 33273057 DOI: 10.1158/1535-7163.mct-20-0173] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 07/10/2020] [Accepted: 11/06/2020] [Indexed: 11/16/2022]
Abstract
Squamous penile cancer displays a rare human papillomavirus (HPV)-associated tumor entity. Investigations on the molecular pathogenesis of HPV-driven penile cancer are impaired by the rareness of clinical specimens and, in particular, are missing relevant cell culture models. Here, we identified in HPV-positive penile cancer cell lines that HPV16 oncoproteins control TP63 expression by modulating critical regulators, while integration into the TP63 open reading frame facilitates oncogene expression. The resulting feed-forward loop leads to elevated p63 levels that in turn enhance the release of the neutrophil-recruiting chemokine CXCL8. Remarkably, elevated CXCL8 amounts lead to the increased surface exposition of the Fc receptor of human IgA antibodies, FcαRI, on neutrophils and correlated with a higher susceptibility to antibody-dependent neutrophil-mediated cytotoxicity (ADCC) using an EGFR-specific IgA2 antibody. IHC staining of tissue microarrays proved that elevated expression of p63 together with neutrophil infiltration were significantly more frequent in HPV-positive penile cancer displaying a higher tumor grade. In summary, we identified a promising marker profile of patients with penile cancer at higher risk for worse prognosis. However, these patients may benefit from immunotherapeutic approaches efficiently engaging neutrophils for tumor cell killing.
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Affiliation(s)
| | - Anabel Zwick
- Institute of Virology, University of Saarland, Homburg, Germany
| | - Tobias Mohr
- Institute of Virology, University of Saarland, Homburg, Germany
| | - Gilles Gasparoni
- Department of Genetics, University of Saarland, Saarbrücken, Germany
| | - Oybek Khalmurzaev
- Department of Urology and Pediatric Urology, University of Saarland, Homburg, Germany.,Department of Urology, Federal State Budgetary Institution "N.N. Blokhin National Medical Research Center of Oncology" of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Vsevolod Borisovich Matveev
- Department of Urology, Federal State Budgetary Institution "N.N. Blokhin National Medical Research Center of Oncology" of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Philine Loertzer
- Department of Urology and Pediatric Urology, University of Saarland, Homburg, Germany
| | - Alexey Pryalukhin
- Institute of Pathology, Saarland University Medical Centre, Homburg, Germany.,Institute of Pathology, University Medical Centre Bonn, Bonn, Germany
| | - Arndt Hartmann
- Institute of Pathology, University Erlangen-Nuremberg, Erlangen, Germany
| | | | - Hagen Loertzer
- Department of Urology and Pediatric Urology, Westpfalz Klinikum, Kaiserslautern, Germany
| | - Heiko Wunderlich
- Department of Urology and Paediatric Urology, St. Georg Klinikum, Eisenach, Germany
| | - Carsten Maik Naumann
- Department of Urology and Pediatric Urology, University Hospital Schleswig Holstein, Kiel, Germany
| | - Holger Kalthoff
- Division of Molecular Oncology, Institute of Experimental Cancer Research, University Hospital Schleswig Holstein, Kiel, Germany
| | - Kerstin Junker
- Department of Urology and Pediatric Urology, University of Saarland, Homburg, Germany
| | - Sigrun Smola
- Institute of Virology, University of Saarland, Homburg, Germany
| | - Stefan Lohse
- Institute of Virology, University of Saarland, Homburg, Germany.
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114
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Kirejczyk S, Pinelli C, Gonzalez O, Kumar S, Dick E, Gumber S. Urogenital Lesions in Nonhuman Primates at 2 National Primate Research Centers. Vet Pathol 2020; 58:147-160. [PMID: 33208023 DOI: 10.1177/0300985820971752] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Given their genetic and anatomic similarities to humans, nonhuman primates (NHPs) may serve as animal models for urogenital diseases of humans. The purpose of this study was to examine the frequency of spontaneous urogenital lesions occurring over a 30-year period at the Yerkes and Southwest National Primate Research Centers and to compare and contrast lesions occurring in Old World versus New World primates. Lesions occurring in the chimpanzee (Pan troglodytes), baboon (Papio spp.), rhesus macaque (Macaca mulatta), cynomolgus macaque (Macaca fascicularis), pig-tailed macaque (Macaca nemestrina), sooty mangabey (Cercocebus atys), common marmoset (Callithrix jacchus), cotton-top tamarin (Sanguinus oedipus), and squirrel monkey (Saimiri sciureus) are discussed. The most common lesions of the kidney were medullary amyloidosis, renal cysts, renal tubular degeneration, glomerulonephritis or glomerulopathy, nephritis, nephrocalcinosis, pyelonephritis, and hydronephrosis. Specific causes of renal tubular disease included pigmentary nephrosis and tubular lipidosis. Renal tumors, including renal adenoma and carcinoma, lymphoma, and nephroblastoma, were infrequent diagnoses in all species. Endometriosis was the most frequently diagnosed lesion of the female genital tract. Of the animals examined in this study, it was most frequent in Old World primates. Leiomyoma was the most common uterine tumor. Granulosa cell tumor was the most frequently observed neoplasm of the ovaries, followed by teratoma. Of animals included in the study, most ovarian tumors occurred in baboons. Neoplasms of the male reproductive tract included interstitial cell tumor, seminoma, penile squamous cell carcinoma, penile papilloma, and histiocytoma. In New World monkeys, renal lesions were reported more frequently than genital lesions.
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Affiliation(s)
| | - Christopher Pinelli
- 1371Emory University, Atlanta, GA, USA.,*Current address: Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, 1161 21st Ave South MCN AA-6206, Nashville, TN 37232, USA
| | - Olga Gonzalez
- 7075Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Shyamesh Kumar
- 7075Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Edward Dick
- 7075Texas Biomedical Research Institute, San Antonio, TX, USA
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115
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Bandini M, Ross JS, Zhu Y, Ye DW, Ornellas AA, Watkin N, Ayres BA, Hakenberg OW, Heidenreich A, Salvioni R, Catanzaro M, Raggi D, Giannatempo P, Marandino L, Haidl F, Pederzoli F, Briganti A, Montorsi F, Chipollini J, Azizi M, De Meerleer G, Brouwer OR, Grass GD, Johnstone PA, Albersen M, Spiess PE, Necchi A. Association Between Human Papillomavirus Infection and Outcome of Perioperative Nodal Radiotherapy for Penile Carcinoma. Eur Urol Oncol 2020; 4:802-810. [PMID: 33199252 DOI: 10.1016/j.euo.2020.10.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/20/2020] [Accepted: 10/30/2020] [Indexed: 01/26/2023]
Abstract
BACKGROUND Data on the impact of human papillomavirus (HPV) infection status and outcomes for perioperative treatments for patients with lymph node-involved penile squamous-cell carcinoma (PSCC) are lacking. OBJECTIVE To analyze the benefit from perioperative radiotherapy (RT) for PSCC according to HPV infection status. DESIGN, SETTING, AND PARTICIPANTS In an international multicenter database of 1254 patients with PSCC who received inguinal lymph node dissection (ILND), 507 had suitable clinical information. INTERVENTION ILND, with or without chemotherapy or RT for involved lymph nodes. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Kaplan-Meier and restricted mean survival time (RMST) analyses for overall survival (OS) were performed for all patients and after propensity score-matching (PSM; n = 136), for which patient age, histology, type of penile surgical procedure, pathological tumor and nodal stage, ILND laterality, pelvic LND, and perioperative treatment were taken into account when assessing differences between HPV+ and HPV- patients. Finally, we looked at genomic alterations in PSCC using data from the Foundation Medicine database (n = 199) to characterize HPV+ PSCC. RESULTS AND LIMITATIONS Patients with HPV+ PSCC (n = 86; 17%) had lower clinical N stage (p < 0.001) and inguinal lymph node metastasis density (p < 0.001). Perioperative RT was delivered in 49 patients (9.7%), with the vast majority receiving adjuvant RT (n = 40). HPV+ patients had similar median OS (p = 0.1) but longer RMST than HPV- patients at different time points. Nevertheless, HPV+ patients treated with perioperative RT exhibited longer median OS (p = 0.015) and longer RMST compared to HPV- patients. In the PSM cohorts, HPV+ status remained significantly associated with longer OS after RT. The HPV- PSCC group had a higher frequency of TP53 mutations compared to HPV+ PSCC (75% vs 15%; p < 0.001). The results are limited by the retrospective nature of the data. CONCLUSIONS Perioperative RT was more effective in the HPV+ PSCC subgroup. Reasons for the enhanced radiosensitivity may be related to the lack of TP53 mutations. PATIENT SUMMARY We analyzed data from a large multicenter database for patients with penile cancer who had received inguinal lymph node dissection, with or without chemotherapy or radiotherapy. We found that for tumors positive for human papillomavirus (HPV), use of radiotherapy resulted in prolonged survival compared to HPV-negative tumors. On the basis of these results we are inspired to design studies on the use of radiotherapy in HPV-selected patients.
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Affiliation(s)
- Marco Bandini
- San Raffaele Hospital and Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Jeffrey S Ross
- Foundation Medicine Inc., Cambridge, MA, USA; Upstate Medical University, Syracuse, NY, USA
| | - Yao Zhu
- Fudan University Shanghai Cancer Center, Shanghai, China
| | - Ding-Wei Ye
- Fudan University Shanghai Cancer Center, Shanghai, China
| | - Antonio A Ornellas
- Hospital Mário Kröeff and Brazilian Cancer Institute, Rio de Janeiro, Brazil
| | - Nick Watkin
- St. George's University Hospitals NHS Foundation Trust, London, UK
| | - Benjamin A Ayres
- St. George's University Hospitals NHS Foundation Trust, London, UK
| | | | | | | | - Mario Catanzaro
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Daniele Raggi
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Laura Marandino
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Filippo Pederzoli
- San Raffaele Hospital and Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Alberto Briganti
- San Raffaele Hospital and Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Francesco Montorsi
- San Raffaele Hospital and Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Juan Chipollini
- Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Mounsif Azizi
- Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | | | - Oscar R Brouwer
- The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - G Daniel Grass
- Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | | | | | | | - Andrea Necchi
- San Raffaele Hospital and Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
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116
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Penile cancer: potential target for immunotherapy? World J Urol 2020; 39:1405-1411. [PMID: 33145666 DOI: 10.1007/s00345-020-03510-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/23/2020] [Indexed: 02/06/2023] Open
Abstract
PURPOSE Penile cancer (PeCa) is a rare malignancy with a poor prognosis in advanced disease. There is still a limited understanding of the biological mediators that are important in the prognosis and therapy of the disease. This review aims to provide a summary of the immune micro-environment, molecular oncogenesis and the role of HPV in the disease applying to the potential of the use of immunotherapy. METHODS Narrative, non-systematic review based on publications retrieved by PubMed and EMBASE search. RESULTS The molecular mechanisms underlying penile carcinogenesis are complex, and human papillomavirus (HPV) infection is a well-characterized driver of penile cancer. Up to 50% of the penile carcinomas are HPV related. There is potential to improve prevention, treatment and follow-up strategies pertaining to the role of HPV in penile cancer. Immune response modifiers such as toll-like receptor agonists are being used in a topical fashion for penile intraepithelial neoplasia while immune checkpoint inhibitors are currently under clinical investigation for its application in penile cancer. CONCLUSIONS The knowledge of prognosis-relevant biological pathways in penile cancer is expanding. HPV plays an important role in the carcinogenesis. This can lead to the identification of therapeutic targets which could significantly influence the prognosis of advanced penile cancer. Clinical trials are being conducted to pave the way for immune-modifying treatment modalities.
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117
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Muresu N, Sotgiu G, Saderi L, Sechi I, Cossu A, Marras V, Meloni M, Martinelli M, Cocuzza C, Tanda F, Piana A. Italian observational study on HPV infection, E6, and p16 expression in men with penile cancer. Virol J 2020; 17:161. [PMID: 33092608 PMCID: PMC7579865 DOI: 10.1186/s12985-020-01424-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 09/30/2020] [Indexed: 12/24/2022] Open
Abstract
Background Human Papillomavirus (HPV) infection is one of the most important causes of cancer. It can play a role in cervical and extra-cervical cancers. Penile cancer is rare, even if an increasing trend was recently reported. Aim of the present study was to assess the prevalence and distribution of HPV genotypes in cases of penile cancer diagnosed in Sardinia, Italy. Surrogate markers of HPV infection (i.e., E6 and p16 genes) were also evaluated in all cases. Methods An observational, retrospective study which recruited all cases of penile cancer diagnosed between 2002 and 2019 at a tertiary care hospital in Sardinia, Italy, was carried out. HPV-DNA detection and genotyping were performed by Real-time PCR. Specimens were tested for oncogene E6 mRNA and for p16(INK4a) expression. Results HPV prevalence was 28.1% (9/32); HPV-16 was the most prevalent genotype (7/9, 77.8%). p16INK4a positivity was found in 66.7% of the samples with a statistically significant difference between HPV-positive and -negative groups. E6-transcript was detected in 71% of the HPV-16 positive samples. The overall survival was not statistically different between HPV-positives and -negatives. Discussion The present study confirms the etiologic role of HPV in penile cancer and supports the adoption of vaccination strategies in men and women. Further studies should clarify the diagnostic and prognostic role of E6 and p16 proteins. Conclusion HPV infection can favor the occurrence of penile cancer, whose diagnosis and prognosis could be improved with the implementation of validated molecular techniques.
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Affiliation(s)
- Narcisa Muresu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via Padre Manzella, 4, 07100, Sassari, Italy
| | - Giovanni Sotgiu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via Padre Manzella, 4, 07100, Sassari, Italy.
| | - Laura Saderi
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via Padre Manzella, 4, 07100, Sassari, Italy
| | - Illari Sechi
- Department of Biomedical Sciences, University of Sassari, 07100, Sassari, Italy
| | - Antonio Cossu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via Padre Manzella, 4, 07100, Sassari, Italy
| | - Vincenzo Marras
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via Padre Manzella, 4, 07100, Sassari, Italy
| | - Marta Meloni
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via Padre Manzella, 4, 07100, Sassari, Italy
| | - Marianna Martinelli
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900, Monza, Italy
| | - Clementina Cocuzza
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900, Monza, Italy
| | - Francesco Tanda
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via Padre Manzella, 4, 07100, Sassari, Italy
| | - Andrea Piana
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via Padre Manzella, 4, 07100, Sassari, Italy
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Watchorn RE, van den Munckhof EHA, Quint KD, Eliahoo J, de Koning MNC, Quint WGV, Bunker CB. Balanopreputial sac and urine microbiota in patients with male genital lichen sclerosus. Int J Dermatol 2020; 60:201-207. [PMID: 33084022 DOI: 10.1111/ijd.15252] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/22/2020] [Accepted: 09/16/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Male genital lichen sclerosus (MGLSc) is a chronic inflammatory scarring dermatosis associated with penile carcinoma. The prepuce is pivotal in its etiology. Other proposed etiological factors are the subject of dispute and include occluded urinary exposure, autoimmunity, immunodysregulation, and infectious agents. OBJECTIVE To determine whether the bacterial microbiota of the balanopreputial sac and urine are associated with MGLSc. SUBJECTS AND METHODS Twenty uncircumcised patients with MGLSc and 20 healthy uncircumcised males were enrolled in a prospective case-control study. Balanopreputial swabs and urine specimens were subjected to 16S rRNA gene amplicon sequencing. RESULTS Microbiota analysis indicated differences between the groups. In the balanopreputial sac, the median relative abundance of Finegoldia spp. was lower (9% [range 0-60%]) in MGLSc patients than in controls (28% [range 0-62%]). Conversely, the median relative abundance of Fusobacterium spp. was higher in MGLSc patients (4% [range 0-41%]) than in controls (0% [range 0-28%]). In the urine, the median relative abundance of Finegoldia spp. was comparable between groups, whereas that of Fusobacterium spp. was higher in MGLSc patients (0% [range 0-18%] vs. 0% [range 0-5%]). There was a strong association between the microbiota composition of the balanopreputial sac and urine in MGLSc. CONCLUSION Dysbiosis could be involved in the etiopathogenesis of MGLSc. Further studies are required to confirm the association suggested herein and to determine its nature.
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Affiliation(s)
| | | | - Koen D Quint
- Department of Dermatology, Leiden University Medical Center, Leiden, Netherlands
| | - Joseph Eliahoo
- Statistical Advisory Service, Imperial College London, London, UK
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119
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Male papillomavirus infection and genotyping in the Qingyuan area. Virol J 2020; 17:155. [PMID: 33076966 PMCID: PMC7574239 DOI: 10.1186/s12985-020-01423-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 09/30/2020] [Indexed: 02/08/2023] Open
Abstract
Background This study aims to screen the male human papillomavirus (HPV) infection status and genotyping in Qingcheng District, Qingyuan City, Guangdong Province, China to provide a reference basis for formulating prevention strategies for HPV infection. Methods The present study collected urethral epithelium or scraped penile epidermis from high-risk male patients in Qingyuan People's Hospital during the last five years, extracted DNA fragments using the boiling method, and detected 23 types of HPV genotypes by PCR-reverse blot hybridization. Results The positive detection rate was 54.31% of 1044 males with high risk of HPV (567/1044). Among these males, the positive detection rate of HPV was the highest in patients initially diagnosed with warts, and the rate was 66.47%. Five main HPV types are identified as follows: HPV6 18.87% (197/1044), HPV11 10.25% (107/1044), HPV52 8.81% (92/1044), HPV16 6.90% (72/1044), and HPV51 5.08% (53/1044). Among these HPV-infected patients, single infection mainly by low-risk HPV6 and HPV11 accounted for 56.61% (321/567); high- and low-risk combined HPV co-infections accounted for 29.10% (165/567). The HPV infected patients was mainly between 21 and 40 years old, and the HPV infection rate was higher with increased age. Conclusions The HPV infection rate in the Qingyuan area is higher than in other areas and the main infection is single infection. Furthermore, HPV52, HPV16, and HPV51 are the main high-risk infection types, while HPV6 and HPV11 are the main low-risk infection types.
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120
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Aydin AM, Chahoud J, Adashek JJ, Azizi M, Magliocco A, Ross JS, Necchi A, Spiess PE. Understanding genomics and the immune environment of penile cancer to improve therapy. Nat Rev Urol 2020; 17:555-570. [DOI: 10.1038/s41585-020-0359-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2020] [Indexed: 02/07/2023]
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121
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Wang N, Ji J, Yu S, Chang J, Chen Y, Yu B. In reply to the letter to the editor regarding "The Relationship Between Serum Vitamin D and Fracture Risk in the Elderly: A Meta-Analysis". J Orthop Surg Res 2020; 15:324. [PMID: 32795312 PMCID: PMC7427934 DOI: 10.1186/s13018-020-01820-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 07/27/2020] [Indexed: 12/14/2022] Open
Affiliation(s)
- Ning Wang
- Shandong University of Traditional Chinese Medicine, Jinan, 250014, China
| | - Jindou Ji
- Shandong University of Traditional Chinese Medicine, Jinan, 250014, China
| | - Shengwen Yu
- Shandong University of Traditional Chinese Medicine, Jinan, 250014, China
| | - Jinlei Chang
- Shandong University of Traditional Chinese Medicine, Jinan, 250014, China
| | - Yungang Chen
- Department of Orthopaedics, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250014, China
| | - Bo Yu
- Department of Orthopaedics, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250014, China.
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Bandini M, Spiess PE, Pederzoli F, Marandino L, Brouwer OR, Albersen M, Roussel E, de Vries HM, Chipollini J, Zhu Y, Ye DW, Ornellas AA, Catanzaro M, Hakenberg OW, Heidenreich A, Haidl F, Watkin N, Ager M, Ahmed ME, Karnes JR, Briganti A, Salvioni R, Montorsi F, Azizi M, Necchi A. A risk calculator predicting recurrence in lymph node metastatic penile cancer. BJU Int 2020; 126:577-585. [PMID: 32662205 DOI: 10.1111/bju.15177] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To develop and externally validate a risk calculator for prediction of any cancer recurrence in patients with penile squamous cell carcinoma (pSCC) and inguinal lymph node metastases (ILNM), as to date no validated prognostic tool is available for patients with pSCC and ILNM. PATIENTS AND METHODS The development cohort included 234 patients from seven referral centres. The external validation cohort included 273 patients from two additional referral centres. Cox regression identified predictors of any recurrence, which were used to develop a risk calculator. The risk-calculator grouped the development and the validation cohorts according to the individual risk of any recurrence at 24 months (24m-R). Adjuvant treatment effects were tested on overall survival (OS) according to the derived tertiles, within the development and validation cohorts. RESULTS Positive surgical margins, pN3 , and ILNM ratio were associated with higher recurrence rate. The 2-year OS rates were lower for patients with high (>37%) and intermediate (19-37%) compared to low (<19%) 24m-R risk of recurrence, for both the development (43% and 58% vs 83%, P < 0.001) and validation cohort (44% and 50% vs 85%, P < 0.001). Results were confirmed in the subgroup of patients who did not receive adjuvant treatment (P < 0.001), but not in patients who did receive adjuvant treatments in both the development and validation cohorts (P > 0.1). CONCLUSION Adjuvant treatment planning is crucial in patients with pSCC with ILNM, where only weak evidence is available. The current tool proved to successfully stratify patients according to their individual risk, potentially allowing better tailoring of adjuvant treatments.
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Affiliation(s)
- Marco Bandini
- Urological Research Institute (URI), Unit of Urology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | | | - Filippo Pederzoli
- Urological Research Institute (URI), Unit of Urology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Laura Marandino
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Oscar R Brouwer
- The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | | | | | - Hielke M de Vries
- The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Juan Chipollini
- Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Yao Zhu
- Fudan University Shanghai Cancer Center, Shanghai, China
| | - Ding-Wei Ye
- Fudan University Shanghai Cancer Center, Shanghai, China
| | - Antonio A Ornellas
- Hospital Mário Kröeff and Brazilian Cancer Institute, Rio de Janeiro, Brazil
| | - Mario Catanzaro
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | | | | | | | - Nick Watkin
- St. George's University Hospitals, NHS Foundation Trust, London, UK
| | - Michael Ager
- St. George's University Hospitals, NHS Foundation Trust, London, UK
| | | | | | - Alberto Briganti
- Urological Research Institute (URI), Unit of Urology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | | | - Francesco Montorsi
- Urological Research Institute (URI), Unit of Urology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Mounsif Azizi
- Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Andrea Necchi
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
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Current management and future perspectives of penile cancer: An updated review. Cancer Treat Rev 2020; 90:102087. [PMID: 32799062 DOI: 10.1016/j.ctrv.2020.102087] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 07/27/2020] [Accepted: 07/29/2020] [Indexed: 02/07/2023]
Abstract
Penile cancer (PeCa) is a rare disease worldwide, accounting for less than one percent of all malignancies in men. It usually presents as a painless ulcer or lump on the head of the penis. Squamous cell carcinoma represents the most common histological subtype of PeCa, with pathogenesis intimately linked to chronic Human Papilloma Virus (HPV) infection. Surgery is the cornerstone for the treatment of primary PeCa with potential mutilating outcome depending on the nodal extension of the disease. However, in case of extensive lymph node involvement, multidisciplinary treatment including perioperative chemotherapy and inclusion in clinical trial should be considered. To date, advanced or metastatic disease still have poor prognosis and are a therapeutic challenge with limited options, highlighting the need of new treatments and further investigations. Growing efforts to identify molecular alterations, understand the role of HPV and characterize immune contexture have expanded over the past years, providing further perspectives in prognostication, predictive biomarkers and therapeutic intervention. In this review, we provide an updated overview of current management of PeCa focusing on perioperative strategy. We discuss about new insights of the biology of PeCa and comment future directions in the field.
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Kravvas G, Ge L, Ng J, Shim TN, Doiron PR, Watchorn R, Kentley J, Panou E, Dinneen M, Freeman A, Jameson C, Haider A, Francis N, Minhas S, Alnajjar H, Muneer A, Bunker CB. The management of penile intraepithelial neoplasia (PeIN): clinical and histological features and treatment of 345 patients and a review of the literature. J DERMATOL TREAT 2020; 33:1047-1062. [DOI: 10.1080/09546634.2020.1800574] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- G. Kravvas
- Department of Dermatology, University College London Hospitals, London, UK
| | - L. Ge
- Department of Dermatology, University College London Hospitals, London, UK
| | - J. Ng
- Department of Dermatology, Chelsea & Westminster Hospital, London, UK
| | - T. N. Shim
- Department of Dermatology, University College London Hospitals, London, UK
| | - P. R. Doiron
- Department of Dermatology, University College London Hospitals, London, UK
| | - R. Watchorn
- Department of Dermatology, University College London Hospitals, London, UK
| | - J. Kentley
- Department of Dermatology, Chelsea & Westminster Hospital, London, UK
| | - E. Panou
- Department of Dermatology, University College London Hospitals, London, UK
| | - M. Dinneen
- Department of Urology, Chelsea & Westminster Hospital, London, UK
| | - A. Freeman
- Department of Histopathology, University College London Hospitals, London, UK
| | - C. Jameson
- Department of Histopathology, University College London Hospitals, London, UK
| | - A. Haider
- Department of Histopathology, University College London Hospitals, London, UK
| | - N. Francis
- Department of Histopathology, Imperial College Hospitals, London, UK
| | - S. Minhas
- Department of Urology, Imperial College Hospitals, London, UK
| | - H. Alnajjar
- Department of Urology, University College London Hospitals, London, UK
| | - A. Muneer
- Department of Urology, University College London Hospitals, London, UK
| | - C. B. Bunker
- Department of Dermatology, University College London Hospitals, London, UK
- Department of Dermatology, Chelsea & Westminster Hospital, London, UK
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de la Cour CD, Sperling CD, Belmonte F, Syrjänen S, Verdoodt F, Kjaer SK. Prevalence of human papillomavirus in oral epithelial dysplasia: Systematic review and meta-analysis. Head Neck 2020; 42:2975-2984. [PMID: 32573035 DOI: 10.1002/hed.26330] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 04/13/2020] [Accepted: 05/27/2020] [Indexed: 12/24/2022] Open
Abstract
The purpose of this systematic review and meta-analysis was to estimate the overall and type-specific prevalence of human papillomavirus (HPV) DNA in oral epithelial dysplasia and assess p16INK4a overexpression in relation to HPV-status. A systematic literature search identified 31 eligible studies (832 cases) evaluating the presence of HPV DNA in oral epithelial dysplasia cases by PCR. Of these, six studies evaluated p16INK4a overexpression in relation to HPV-status. The overall pooled prevalence of HPV DNA in oral epithelial dysplasia was 27.2% (95% CI: 17.6-38.1). We observed substantial interstudy heterogeneity, which could not be explained by differences in continent, tissue type, or severity of epithelial dysplasia. HPV16 was the predominant genotype detected. Moreover, 62.2% of HPV positive and 17.8% of HPV negative oral epithelial dysplasia samples stained intensively positive for p16INK4a . This meta-analysis found that 27% of oral epithelial dysplasia harbor HPV DNA. Whether this represents a transient infection or has a carcinogenic role is unknown.
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Affiliation(s)
| | - Cecilie Dyg Sperling
- Danish Cancer Society Research Center, Unit of Virus, Lifestyle and Genes, Copenhagen, Denmark
| | - Federica Belmonte
- Unit of Statistics and Pharmacoepidemiology, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Stina Syrjänen
- Department of Oral Pathology, Institute of Dentistry, University of Turku, Turku, Finland.,Department of Pathology, University of Turku and Turku University Hospital, Turku, Finland
| | - Freija Verdoodt
- Danish Cancer Society Research Center, Unit of Virus, Lifestyle and Genes, Copenhagen, Denmark
| | - Susanne Krüger Kjaer
- Danish Cancer Society Research Center, Unit of Virus, Lifestyle and Genes, Copenhagen, Denmark.,Department of Gynecology, University of Copenhagen and Copenhagen University Hospital, Copenhagen, Denmark
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Jayaraj R, Kumarasamy C, Sabarimurugan S, Madhav MR. Meta-analysis of penile cancer: conceptual interpretations. Lancet Oncol 2020; 20:e125. [PMID: 30842049 DOI: 10.1016/s1470-2045(19)30023-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 01/10/2019] [Accepted: 01/11/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Rama Jayaraj
- College of Health and Human Sciences, Charles Darwin University, Ellengowan Drive, Darwin, NT 0909, Australia.
| | | | - Shanthi Sabarimurugan
- School of Biosciences and Technology, Vellore Institute of Technology, Vellore, Tamil Nadu, India
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127
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Lu Y, Li P, Luo G, Liu D, Zou H. Cancer attributable to human papillomavirus infection in China: Burden and trends. Cancer 2020; 126:3719-3732. [PMID: 32484937 DOI: 10.1002/cncr.32986] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 04/07/2020] [Accepted: 04/28/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) is associated with a substantial percentage of cervical cancer, and a significant percentage of anal, penile, vaginal, vulvar, oral cavity, oropharyngeal, and laryngeal cancers. Understanding the burden and trends of HPV-attributable cancers is crucial to HPV prevention strategies. In the current study, the authors estimated the latest burden and trends of HPV-attributable cancers in China. METHODS Data from the following sources were used. The number of new cancer cases and cancer deaths in China were estimated based on the China Cancer Registry Annual Report. The population-attributable fraction was estimated using pooled high-risk HPV prevalence and biomarker-positive rates, which were calculated using random effects meta-analyses. Cancer burden estimates were stratified by anatomic site, sex, and age. RESULTS In 2015, a total of 110,650 new cancer cases and 36,714 cancer deaths attributable to HPV infection were estimated to have occurred in China, of which cervical cancer accounted for 85.6% and 78.1%, respectively. The age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) of HPV-attributable cancers were 5.63 and 1.81 per 100,000 person-years, respectively. The ASIR and ASMR both varied by anatomic site, with the highest rates noted for cervical cancer at 4.83 and 1.42 per 100,000 person-years, respectively. Between 2005 and 2015, the ASIR and ASMR demonstrated significant upward trends for all HPV-attributable cancers combined. CONCLUSIONS Between 2005 and 2015, cervical cancer accounted for the vast majority of HPV-attributable cancers and its incidence and mortality increased rapidly in China. The comprehensive prevention of cervical cancer remains the most important target in the prevention of HPV-attributable cancers.
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Affiliation(s)
- Yong Lu
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Peiyang Li
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ganfeng Luo
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Di Liu
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China.,Kirby Institute, The University of New South Wales, Sydney, New South Wales, Australia
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128
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Chu C, Chen K, Tan X, Lu J, Yang Y, Zhang Y, Yao K, Cao Y. Prevalence of human papillomavirus and implication on survival in Chinese penile cancer. Virchows Arch 2020; 477:667-675. [PMID: 32430598 DOI: 10.1007/s00428-020-02831-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 04/07/2020] [Accepted: 04/27/2020] [Indexed: 12/17/2022]
Abstract
We assessed the prevalence of HPV DNA in a large series of Chinese penile cancer and examine its association with the histological subtype, p16INK4a expression, and prognosis. We pathologically categorized 226 invasive penile squamous cell carcinomas and assessed HPV genotyping by real-time PCR and p16INK4a immunohistochemistry. The results were correlated with histopathological and clinical parameters and disease-specific survival (DSS). HPV DNA was detected in 32.7% (74/226) of penile cancer cases. The most frequent genotype was HPV 16 (64/74, 86.5%), followed by HPV 18 (6/74, 8.1%). Fifty-nine (26.1%) cases were positive for the p16INK4a expression, and p16INK4a expression had a sensitivity of 56.8% (95% CI, 45.2-68.3%) and a specificity of 88.8% (95% CI, 83.8-93.9%) for defining HPV status. HPV DNA (P = 0.019), p16INK4a (P = 0.038), age (P = 0.018), grade of differentiation (P = 0.001), lymph nodes (P < 0.001), T stage (P < 0.001), M stage (P < 0.001), and lymphovascular invasion (LVI, P = 0.001) were prognostic factors for DSS. HPV-positivity (HR 0.334; 95% CI, 0.158-0.705, P = 0.004) was still a significant prognostic factor for DSS in the multivariate Cox regression model. HPV DNA was observed in one third of Chinese penile carcinoma cases. The p16INK4a expression can indicate high-risk human papillomavirus (HR-HPV). HPV-positive penile tumors confer a survival benefit over HPV-negative tumors.
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Affiliation(s)
- Chengbiao Chu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
| | - Keming Chen
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
| | - Xingliang Tan
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
| | - Jiangli Lu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
| | - Yuanzhong Yang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
| | - YiJun Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
| | - Kai Yao
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.
| | - Yun Cao
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.
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129
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Martins VDCA, Cunha IW, Figliuolo G, Rondon HHDMF, de Souza PM, Torres Silva FL, Torres Silva GL, de Souza Bastos M, de Castro DB, Santana MF, Ramasawmy R, Levi JE, Torres KL. Presence of HPV with overexpression of p16INK4a protein and EBV infection in penile cancer-A series of cases from Brazil Amazon. PLoS One 2020; 15:e0232474. [PMID: 32374757 PMCID: PMC7202603 DOI: 10.1371/journal.pone.0232474] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 04/15/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND In Brazil, penile cancer (PC) is not uncommon. The highest incidence of PC is in the North and Northeast of the country. In addition to phimosis, the Human Papillomavirus (HPV) and Epstein-Baar Virus (EBV) infections are also related as risk factors for PC. The overexpression of p16INK4a is a surrogate sensitive marker of HPV infection in PC. OBJECTIVES To correlate p16INK4a overexpression and HPV infection status with EBV infection in a series of PC patients from the Amazon region. METHODS Tumor tissues from 47 PC cases were analyzed for the presence of HPV and EBV DNA by PCR. All PC patients were diagnosed between 2013 and 2018 at a public reference cancer center hospital in Manaus, Amazonas-Brazil. HPV was genotyped using E7 HPV16/HPV18 type-specific real-time PCR and the PapilloCheck® HPV-Screening assay. p16INK4a expression was evaluated by immunohistochemistry using the automated Ventana® BenchMark Ultra. RESULTS The mean age of patients at the time of diagnosis was 57.4 years ±SD 17.8 ranging from 20 to 90 years old. Most of the patients (64%) came from rural areas of the Amazonas State. Thirty patients had phimosis (64%). Among the patients with phimosis, 43% (13/30) underwent circumcision, three during childhood and 10 in adulthood. 60% of the patients were smokers or ex-smokers. HPV infection was observed in 45% (21/47) of cases. HPV16 was detected in 13 patients (61%). Other HPV types detected were HPV 6, 11, 42, 51, 53, 68 and 44/55. EBV infection was observed in 30% (14/47) of the patients with PC. Co-infection with HPV and EBV was observed in 28% (6/21) cases. p16INK4a was only investigated in 26 samples. The p16INK4a overexpression was observed exclusively in HPV 16 positive cases and four HPV negative cases. In the survival analysis, the follow-up time was 35.4 months/patient. The mortality rate during the follow up time was 38%. CONCLUSIONS p16INK4a positivity presented a high correlation to HPV 16 DNA detection, reinforcing its use as a surrogate marker for HPV-driven cancers. Infection with EBV was quite frequent and its role in epithelial penile oncogenesis needs to be demonstrated.
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Affiliation(s)
- Valquíria do Carmo Alves Martins
- Department of Education and Research, Fundação Centro de Controle de Oncologia do Estado do Amazonas, Manaus, Amazonas, Brazil
- Universidade Federal do Amazonas, Manaus, Amazonas, Brazil
- Genomic Health Surveillance Network: Optimization of Assistance and Research in The State of Amazonas – REGESAM, Manaus, Amazonas, Brazil
| | - Isabela Werneck Cunha
- Department of Pathology, AC Camargo Cancer Center, São Paulo, Brazil
- Department of Pathology, Rede D’OR- São Luiz, São Paulo, Brazil
| | - Giuseppe Figliuolo
- Department of Education and Research, Fundação Centro de Controle de Oncologia do Estado do Amazonas, Manaus, Amazonas, Brazil
- Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | | | | | | | | | - Michele de Souza Bastos
- Department of Virology, Fundação de Medicina Tropical Heitor Vieira Dourado, Manaus, Amazonas, Brazil
| | - Daniel Barros de Castro
- Genomic Health Surveillance Network: Optimization of Assistance and Research in The State of Amazonas – REGESAM, Manaus, Amazonas, Brazil
- Technical Advisory, Fundação de Vigilância em Saúde do Amazonas, Manaus, Amazonas, Brazil
| | - Monique Freire Santana
- Department of Education and Research, Fundação Centro de Controle de Oncologia do Estado do Amazonas, Manaus, Amazonas, Brazil
- Department of Virology, Fundação de Medicina Tropical Heitor Vieira Dourado, Manaus, Amazonas, Brazil
| | - Rajendranath Ramasawmy
- Genomic Health Surveillance Network: Optimization of Assistance and Research in The State of Amazonas – REGESAM, Manaus, Amazonas, Brazil
- Department of Virology, Fundação de Medicina Tropical Heitor Vieira Dourado, Manaus, Amazonas, Brazil
- Faculdade de Medicina, Universidade Nilton Lins, Manaus, Amazonas, Brazil
| | - José Eduardo Levi
- Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, Brazil
| | - Kátia Luz Torres
- Department of Education and Research, Fundação Centro de Controle de Oncologia do Estado do Amazonas, Manaus, Amazonas, Brazil
- Universidade Federal do Amazonas, Manaus, Amazonas, Brazil
- Genomic Health Surveillance Network: Optimization of Assistance and Research in The State of Amazonas – REGESAM, Manaus, Amazonas, Brazil
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130
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Huang T, Cheng X, Chahoud J, Sarhan A, Tamboli P, Rao P, Guo M, Manyam G, Zhang L, Xiang Y, Han L, Shang X, Deng P, Luo Y, Lu X, Feng S, Ferrer MM, Alan Wang Y, DePinho RA, Pettaway CA, Lu X. Effective combinatorial immunotherapy for penile squamous cell carcinoma. Nat Commun 2020; 11:2124. [PMID: 32358507 PMCID: PMC7195486 DOI: 10.1038/s41467-020-15980-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 04/07/2020] [Indexed: 12/13/2022] Open
Abstract
Penile squamous cell carcinoma (PSCC) accounts for over 95% of penile malignancies and causes significant mortality and morbidity in developing countries. Molecular mechanisms and therapies of PSCC are understudied, owing to scarcity of laboratory models. Herein, we describe a genetically engineered mouse model of PSCC, by co-deletion of Smad4 and Apc in the androgen-responsive epithelium of the penis. Mouse PSCC fosters an immunosuppressive microenvironment with myeloid-derived suppressor cells (MDSCs) as a dominant population. Preclinical trials in the model demonstrate synergistic efficacy of immune checkpoint blockade with the MDSC-diminishing drugs cabozantinib or celecoxib. A critical clinical problem of PSCC is chemoresistance to cisplatin, which is induced by Pten deficiency on the backdrop of Smad4/Apc co-deletion. Drug screen studies informed by targeted proteomics identify a few potential therapeutic strategies for PSCC. Our studies have established what we believe to be essential resources for studying PSCC biology and developing therapeutic strategies.
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Affiliation(s)
- Tianhe Huang
- Department of Biological Sciences, Boler-Parseghian Center for Rare and Neglected Diseases, Harper Cancer Research Institute, University of Notre Dame, Notre Dame, IN, 46556, USA
- Tumor Microenvironment and Metastasis Program, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN, 46202, USA
- Department of Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Xi Cheng
- Department of Biological Sciences, Boler-Parseghian Center for Rare and Neglected Diseases, Harper Cancer Research Institute, University of Notre Dame, Notre Dame, IN, 46556, USA
- Tumor Microenvironment and Metastasis Program, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN, 46202, USA
- Department of General Surgery, , Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 200025, Shanghai, China
| | - Jad Chahoud
- Department of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Ahmed Sarhan
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Pheroze Tamboli
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Priya Rao
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Ming Guo
- Department of Pathology/Lab Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Ganiraju Manyam
- Department of Bioinformatics & Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Li Zhang
- Department of Environmental Health, University of Cincinnati, Cincinnati, OH, 45267, USA
| | - Yu Xiang
- Department of Biochemistry and Molecular Biology, The University of Texas Health Science Center at Houston McGovern Medical School, Houston, TX, 77030, USA
| | - Leng Han
- Department of Biochemistry and Molecular Biology, The University of Texas Health Science Center at Houston McGovern Medical School, Houston, TX, 77030, USA
| | - Xiaoying Shang
- Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Pingna Deng
- Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Yanting Luo
- Department of Biological Sciences, Boler-Parseghian Center for Rare and Neglected Diseases, Harper Cancer Research Institute, University of Notre Dame, Notre Dame, IN, 46556, USA
| | - Xuemin Lu
- Department of Biological Sciences, Boler-Parseghian Center for Rare and Neglected Diseases, Harper Cancer Research Institute, University of Notre Dame, Notre Dame, IN, 46556, USA
| | - Shan Feng
- Mass Spectrometry Core Facility, School of Life Sciences, Westlake University, Hangzhou, 310024, Zhejiang, China
| | - Magaly Martinez Ferrer
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Puerto Rico, San Juan, PR, 00936, USA
- University of Puerto Rico Comprehensive Cancer Center, Medical Sciences Campus, San Juan, PR, 00936, USA
| | - Y Alan Wang
- Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Ronald A DePinho
- Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Curtis A Pettaway
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Xin Lu
- Department of Biological Sciences, Boler-Parseghian Center for Rare and Neglected Diseases, Harper Cancer Research Institute, University of Notre Dame, Notre Dame, IN, 46556, USA.
- Tumor Microenvironment and Metastasis Program, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN, 46202, USA.
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Tanaka K, Kandori S, Nitta S, Chihara I, Kojo K, Nagumo Y, Kimura T, Kojima T, Kawai K, Okuyama A, Higashi T, Nishiyama H. Characteristics of penile cancer in Japan: An analysis of nationwide hospital-based cancer registry data. Int J Urol 2020; 27:538-542. [PMID: 32307745 DOI: 10.1111/iju.14247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 03/01/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To investigate the clinical characteristics of patients with penile cancer in Japan using the nationwide hospital-based cancer registry database. METHODS Using hospital-based cancer registry data, we described the distribution of age, pathology, tumor-node-metastases classification, and first-course treatment in patients treated between 2012 and 2015. We compared the patterns of first-line treatment between elderly and non-elderly patients. RESULTS A total of 1012 patients were diagnosed with squamous cell carcinoma among 1773 patients with penile tumors who registered under topography code C60. The median age at diagnosis was 74 years, and 85.9% of patients were aged >60 years. The most common pathology was usual-type squamous cell carcinoma (91.9%), followed by verrucous carcinoma (5.0%), sarcomatoid carcinoma (1.1%), papillary carcinoma (0.7%), basaloid carcinoma (0.6%), adenosquamous carcinoma (0.4%), warty carcinoma (0.2%) and mixed carcinoma (0.1%). A total of 61.3% of patients were diagnosed with localized disease. In contrast, the proportions of patients with lymph node and distant metastases were 27.5% and 2.1% at diagnosis, respectively. The proportion of patients who were treated with chemotherapy as the first-course treatment was significantly lower among elderly patients (≥80 years) with clinical stage III (27.6% vs 7.1%, P = 0.0312) and clinical stage IV (53.2% vs 14.3%, P = 0.0086). CONCLUSIONS Most penile cancer patients in Japan are diagnosed with usual-type squamous cell carcinoma, and those with human papilloma virus-related squamous cell carcinomas are <1%. Chemotherapy for advanced penile cancer is administered less in Japanese elderly (≥80 years) patients.
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Affiliation(s)
- Ken Tanaka
- Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Shuya Kandori
- Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Satoshi Nitta
- Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Ichiro Chihara
- Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kosuke Kojo
- Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yoshiyuki Nagumo
- Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Tomokazu Kimura
- Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Takahiro Kojima
- Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Koji Kawai
- Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Ayako Okuyama
- Centre for Cancer Registries, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
| | - Takahiro Higashi
- Centre for Cancer Registries, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
| | - Hiroyuki Nishiyama
- Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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Report From the International Society of Urological Pathology (ISUP) Consultation Conference on Molecular Pathology of Urogenital Cancers V. Am J Surg Pathol 2020; 44:e80-e86. [DOI: 10.1097/pas.0000000000001477] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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133
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Chahoud J, Pickering CR, Pettaway CA. Genetics and penile cancer: recent developments and implications. Curr Opin Urol 2020; 29:364-370. [PMID: 31045928 DOI: 10.1097/mou.0000000000000640] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE OF REVIEW We summarize the recent developments in the molecular landscape of penile squamous cell carcinoma (PSCC). RECENT FINDINGS Recent genomic studies have demonstrated a molecular convergence of PSCC with other squamous cell carcinomas (SCCs) from different organ sites. Similarly, human papillomavirus (HPV)-related PSCCs appear to have epigenetic and genomic similarities with other HPV-related cancers. This could have implications on future HPV-related cancer trial design. Growing efforts to characterize recurrent gene alterations in PSCC have expanded our understanding over the past years, showing a predominance of tumor suppressor gene alterations such as TP53 and NOTCH1. In addition, these studies have demonstrated that at least 30% of PSCC cases have targetable gene alterations. Further, the similar tumor mutational burden with other SCCs and the relatively high rates of programmed death-1 (PD-1) positive expression in PSCC constitute the rationale for investigation of PD-1 inhibition in ongoing clinical trials. Multiple studies have identified potential epigenetic and RNA signatures predictive of metastasis or survival, but these still require validation in larger cohorts. SUMMARY PSCC appears to be genomicaly similar to other SCCs and HPV-related cancers. This provides the rationale and opportunity to include a rare tumor like PSCC in future 'basket type' trials using novel agents targeting multiple SCCs that may exhibit similar biology.
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Affiliation(s)
| | | | - Curtis A Pettaway
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Martínez-Bailón C, Mantilla-Morales A, Méndez-Matías G, Alvarado-Cabrero I, Maldonado-Rodríguez R, Quintero-Becerra J, Arias-Flores R, Piña-Sánchez P. Human papillomavirus genotypes and P16INK4A expression in squamous penile carcinoma in Mexican patients. BMC Infect Dis 2019; 19:1068. [PMID: 31856740 PMCID: PMC6924036 DOI: 10.1186/s12879-019-4696-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 12/09/2019] [Indexed: 01/22/2023] Open
Abstract
Background Approximately 50% of cases of penile carcinoma (PeCa), a rare neoplasm worldwide, are associated with human papillomavirus (HPV). However, the detection of HPV-DNA is not sufficient to consider it the etiological factor in the development of this type of cancer. Currently, the overexpression of P16INK4A is used as a surrogate biomarker of HPV carcinogenesis. Information on PeCa in Mexico is scarce, particularly regarding cases related to HPV and genotype frequency. Objective To evaluate the presence of HPV, its genotypes, and the presence of multiple genotypes, and the expression of P16INK4A, as well as its clinical and histopathological parameters. Methods For HPV-DNA detection and P16INK4A expression, we used the INNO-LiPA® test and immunohistochemistry, respectively. Results Sixty cases of PeCa were evaluated, of which 75% were HPV-non-related histological variants. We found that 58.9% (33/56) of PeCa cases were HPV-DNA positive, while 30.9% of the cases evaluated (17/55) were positive for P16INK4A. HPV16 was the main genotype in 42.9% of the cases, followed by HPV52 in 7.1% and HPV18 in 5.4%. Within the HPV-positive cases, 27.3% had multiple genotypes. All HPV-positive patients under the age of 45 years were positive only for HPV16. Conclusions HPV16 was the most commonly detected genotype in PeCa. HPV 31, 35 and 39 were infrequent; however, they were related to a single infection and P16INK4A overexpression; thus, they seem to be relevant in PeCa carcinogenesis. Our results suggest that P16INK4A overexpression could be useful for the classification of HPV-related PeCa. The role of multiple HPV genotypes in the development and prognosis of PeCa is still not completely understood. Thus, it is necessary to define criteria to establish reliable ways to classify HPV-related PeCa that could lead to optimal therapeutic approaches.
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Affiliation(s)
- Cecilia Martínez-Bailón
- Molecular Oncology Laboratory, Oncology Research Unit, Instituto Mexicano del Seguro Social, CMN S XXI IMSS, Mexico City, Mexico
| | - Alejandra Mantilla-Morales
- Department of Pathology, UMAE Oncology Hospital, Instituto Mexicano del Seguro Social, CMN S XXI IMSS, Mexico City, Mexico
| | - Galo Méndez-Matías
- Molecular Oncology Laboratory, Oncology Research Unit, Instituto Mexicano del Seguro Social, CMN S XXI IMSS, Mexico City, Mexico
| | - Isabel Alvarado-Cabrero
- Department of Pathology, UMAE Oncology Hospital, Instituto Mexicano del Seguro Social, CMN S XXI IMSS, Mexico City, Mexico
| | - Rogelio Maldonado-Rodríguez
- Department of Biochemistry, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico
| | - Joel Quintero-Becerra
- Department of Urology, UMAE Oncology Hospital, Instituto Mexicano del Seguro Social, CMN S XXI, Mexico City, Mexico
| | - Rafael Arias-Flores
- Department of Epidemiology, UMAE Pediatrics Hospital, Instituto Mexicano del Seguro Social, CMN S XXI, Mexico City, Mexico
| | - Patricia Piña-Sánchez
- Molecular Oncology Laboratory, Oncology Research Unit, Instituto Mexicano del Seguro Social, CMN S XXI IMSS, Mexico City, Mexico.
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Lebentrau S, Wolff I, Hempel MC, Haccius M, Kluth LA, Pycha A, Brookman-May S, Schneider TR, Hermanns T, Distler FA, Boegemann M, Kübler H, Shariat SF, Burger M, May M. [Knowledge of German-speaking urologists regarding the association between penile cancer and human papilloma virus: results of a survey of the European PROspective Penile Cancer Study (E-PROPS)]. Aktuelle Urol 2019; 53:461-467. [PMID: 31745963 DOI: 10.1055/a-1032-8086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND A recent meta-analysis showed that penile cancer (PeC) is associated with the human papilloma virus (HPV) in 50 % of patients in Europe. It is unknown whether urologists are aware of the impact of viral carcinogenesis. METHODS A (German-language) survey comprising 14 items was created and sent to urologists of 45 clinical centres in Germany (n = 34), Austria (n = 8), Switzerland (n = 2) and Italy/South Tyrol (n = 1) once in Q3/2018. According to a predefined quality standard, a total of 557 surveys were eligible for final data analysis (response rate: 85.7 %). Among other questions, urologists were asked to state the frequency of HPV-associated PeC in Europe. 4 potential answers were provided: (A)-"< 25 %", (B)-"25 - 50 %", (C)-"> 50 - 75 %", (D)-"level of association unknown". For the final calculation, a tolerance of ± 50 % was considered acceptable, so B and C were deemed correct answers. Based on a bootstrap-adjusted multivariate logistic regression model, criteria independently predicting a correct answer were identified. RESULTS Categories A-D were selected in 19.2 % (n = 107), 48.8 % (n = 272), 12.9 % (n = 72) and 19 % (n = 106), respectively, representing a rate of 61.8 % of urologists (n = 344) reaching the endpoint (B + C). Autonomous performance of chemotherapy for PeC by urologists within the given centre (OR 1.55, p[Bootstrap] = 0.036) and the centre's number of urological beds (OR 1.02, p[Bootstrap] = 0.025) were the only parameters showing a significant independent impact on the endpoint. In contrast, the status of a university centre (p = 0.143), a leading position of the responding urologist (p = 0.375) and the number of PeC patients treated per year and centre (p = 0.571) did not significantly predict a correct answer. CONCLUSIONS Our results demonstrate insufficient knowledge on the association of PeC and HPV among German-speaking urologists.
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Affiliation(s)
- Steffen Lebentrau
- Urologische Klinik, Ruppiner Kliniken GmbH, Medizinische Hochschule Brandenburg Theodor Fontane, Neuruppin, Deutschland
| | - Ingmar Wolff
- Klinik und Poliklinik für Urologie, Universitätsmedizin Greifswald, Deutschland
- Klinik für Urologie und Neuro-Urologie, Unfallkrankenhaus Berlin, Deutschland
| | | | - Marlene Haccius
- Urologische Klinik, St. Elisabeth-Klinikum Straubing, Deutschland
| | - Luis A. Kluth
- Urologische Klinik, Universitätsklinik Frankfurt/M., Deutschland
| | - Armin Pycha
- Urologische Klinik, Klinikum Bozen, Italien
- Sigmund Freud Private University, Medical School Vienna, Österreich
| | | | | | - Thomas Hermanns
- Klinik für Urologie, Universitätsspital Zürich, Universität Zürich, Schweiz
| | - Florian A. Distler
- Urologische Universitätsklinik, Paracelsus Medizinische Privatuniversität am Klinikum Nürnberg, Deutschland
| | - Martin Boegemann
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Münster, Deutschland
| | - Hubert Kübler
- Urologische Klinik, Universitätsklinik Würzburg, Deutschland
| | | | - Maximilian Burger
- Urologische Klinik, Caritas-Krankenhaus St. Josef, Universitätsklinik Regensburg, Deutschland
| | - Matthias May
- Urologische Klinik, St. Elisabeth-Klinikum Straubing, Deutschland
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Eich ML, Del Carmen Rodriguez Pena M, Schwartz L, Granada CP, Rais-Bahrami S, Giannico G, Amador BM, Matoso A, Gordetsky JB. Morphology, p16, HPV, and outcomes in squamous cell carcinoma of the penis: a multi-institutional study. Hum Pathol 2019; 96:79-86. [PMID: 31698006 DOI: 10.1016/j.humpath.2019.09.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 09/12/2019] [Indexed: 12/11/2022]
Abstract
Our objective was to evaluate the pathologic features and clinical outcomes in cases of invasive penile squamous cell carcinoma (SCC) and the association with p16 immunohistochemistry (IHC) and human papilloma virus (HPV) in situ hybridization (ISH). A retrospective multi-institutional database search was conducted for invasive SCC of the penis diagnosed between 2007 and 2018 that had undergone surgical resection. Pathologic features, p16 IHC, and HPV ISH were investigated with clinical outcomes. A total of 102 patients were included in the study. The average age was 63 ± 13.3 years. Based on histology, 46% of tumors displayed an HPV-related subtype, whereas p16 was positive in 52% of all cases. Tumor histology correlated well with p16 positivity (P < .001), and p16 IHC accurately predicted the presence of HPV in 25/26 (96%) cases. On multivariate analysis, perineural invasion was associated with local disease recurrence (P = .02), whereas lymphovascular invasion was associated with progression to metastatic disease (P = .002) and increased overall mortality (P = .02). Urethral involvement was also associated with increased overall mortality (P = .02). In addition, HPV-related tumors based on histologic features correlated with lower rates of metastatic disease (P = .007). HPV is a common cause of penile SCC and can be diagnosed by tumor histology and confirmed by overexpression of p16 on IHC. The presence of lymphovascular invasion, perineural invasion, and urethral involvement are poor prognostic indicators, whereas HPV-related tumors based on histology may have lower risk for metastatic disease.
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Affiliation(s)
- Marie-Lisa Eich
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, 35294 USA
| | | | - Lauren Schwartz
- Department of Pathology, University of Pennsylvania, Philadelphia, PA, 19104 USA
| | - Carlos Prieto Granada
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, 35294 USA
| | - Soroush Rais-Bahrami
- Department of Urology, University of Alabama at Birmingham, Birmingham, AL, 35294 USA; Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, 35294 USA; O'Neal Comprehensive Cancer Center at UAB, University of Alabama at Birmingham, Birmingham, AL, 35294 USA
| | - Giovanna Giannico
- Department of Pathology, Vanderbilt University, Nashville, TN, 37212 USA
| | | | - Andres Matoso
- Department of Pathology, Johns Hopkins University, Baltimore, MD, 21287 USA
| | - Jennifer B Gordetsky
- Department of Pathology, Vanderbilt University, Nashville, TN, 37212 USA; Department of Urology, Vanderbilt University, Nashville, TN, 37212 USA.
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Reinholdt K, Thomsen LT, Dehlendorff C, Larsen HK, Sørensen SS, Hædersdal M, Kjær SK. Human papillomavirus‐related anogenital premalignancies and cancer in renal transplant recipients: A Danish nationwide, registry‐based cohort study. Int J Cancer 2019; 146:2413-2422. [DOI: 10.1002/ijc.32565] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 06/21/2019] [Accepted: 07/02/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Kristian Reinholdt
- Unit of Virus, Lifestyle and Genes Danish Cancer Society Research Center Copenhagen Denmark
| | - Louise T. Thomsen
- Unit of Virus, Lifestyle and Genes Danish Cancer Society Research Center Copenhagen Denmark
| | - Christian Dehlendorff
- Unit of Statistics and Pharmacoepidemiology Danish Cancer Society Research Center Copenhagen Denmark
| | - Helle K. Larsen
- Unit of Virus, Lifestyle and Genes Danish Cancer Society Research Center Copenhagen Denmark
- Department of Dermato‐Venerology Bispebjerg Hospital, Copenhagen University Hospital Copenhagen Denmark
| | - Søren S. Sørensen
- Department of Nephrology, Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
| | - Merete Hædersdal
- Department of Dermato‐Venerology Bispebjerg Hospital, Copenhagen University Hospital Copenhagen Denmark
| | - Susanne K. Kjær
- Unit of Virus, Lifestyle and Genes Danish Cancer Society Research Center Copenhagen Denmark
- Department of Gynecology, Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
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138
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Pathology of Invasive and Intraepithelial Penile Neoplasia. Eur Urol Focus 2019; 5:713-717. [PMID: 31288989 DOI: 10.1016/j.euf.2019.06.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 05/10/2019] [Accepted: 06/21/2019] [Indexed: 11/23/2022]
Abstract
Since 1995 it has been known that tumors harboring human papillomavirus (HPV) preferentially show basaloid or condylomatous histological features, while HPV-negative tumors have a different morphology. New classification models separate subtypes of penile squamous cell carcinomas in two groups, non-HPV- and HPV-related. It is purported that HPV-related tumors have better prognosis. Other features such as inflammatory cell-rich medullary, clear-cell, and lymphoepithelioma-like patterns are also strong predictors of the presence of HPV. These tumors are morphologically distinctive and with some experience, pathologists may recognize them after routine hematoxylin and eosin staining. Occasionally, p16 immunostaining may aid in differential diagnosis. The gold standard for HPV detection is polymerase chain reaction, but this technique is expensive and not available in most pathology laboratories. In situ hybridization is useful and p16 immunostaining can detect HPV in approximately 85% of cases. There is correlation between morphology and outcome. PATIENT SUMMARY: This mini review provides an overview of the latest classification for penile invasive carcinoma and penile intraepithelial neoplasia.
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139
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Al-Awadhi R, Al-Mutairi N, Albatineh AN, Chehadeh W. Association of HPV genotypes with external anogenital warts: a cross sectional study. BMC Infect Dis 2019; 19:375. [PMID: 31046696 PMCID: PMC6498701 DOI: 10.1186/s12879-019-4005-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 04/18/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND This study was undertaken to determine the distribution of type-specific human papillomavirus (HPV) in external anogenital warts, and the correlation with clinical presentation of warts and demographic data of patients. METHODS Genital warts specimens were obtained from 129 men and 27 women attending a dermatology clinic, who had been advised surgical excision. The tissues were fixed and screened for HPV DNA by using real-time PCR. HPV genotype was determined by PCR-based sequencing. RESULTS Sixteen different HPV genotypes were detected, comprising 4 oncogenic HPV genotypes (16, 18, 33, 38), 2 low-risk HPV types (LR) (6, 81), HPV 9, and other types associated with common warts (1a, 2, 4, 7, 27b, 27, 57b, 57c, 65). Oncogenic HPV types were found in 34.62% of patients, LR HPV types in 14.4%, HPV 9 in 0.64%, and common warts type in 50.6%. The prevalence of HPV infection with a single type was 88.4, 9.0% for two types, and 2.6% for three types. Multiple logistic regression model showed that age, gender, nationality, number of warts, size of each wart, and positive history of wart in sexual partner, were not predictors of HPV type. However, patients with anogenital warts of one to six months duration were three times more likely to have oncogenic HPV infection compared to those with less than one month. CONCLUSIONS This study shows that oncogenic HPV types are detected in around 35% of patients with genital warts, and are prevalent in warts of one to six months duration.
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Affiliation(s)
- Rana Al-Awadhi
- Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, Kuwait University, P.O. Box 31470, 90805, Sulaibikhat, Kuwait.
| | - Nawaf Al-Mutairi
- Dermatology Unit, Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Ahmed N Albatineh
- Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Wassim Chehadeh
- Virology Unit, Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
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Albieri V, Olesen TB, Sand FL, Rasmussen CL, Toft BG, Norrild B, Munk C, Kjær SK. Meta-analysis of penile cancer: conceptual interpretations - Authors' reply. Lancet Oncol 2019; 20:e126. [PMID: 30842050 DOI: 10.1016/s1470-2045(19)30108-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 02/19/2019] [Indexed: 12/30/2022]
Affiliation(s)
- Vanna Albieri
- Unit of Statistics and Pharmacoepidemiology, Danish Cancer Society Research Centre, Copenhagen, Denmark
| | - Tina Bech Olesen
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Centre, DK-2100 Copenhagen, Denmark
| | - Freja Lærke Sand
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Centre, DK-2100 Copenhagen, Denmark
| | | | | | - Bodil Norrild
- Department of Cellular and Molecular Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Christian Munk
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Centre, DK-2100 Copenhagen, Denmark
| | - Susanne Krüger Kjær
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Centre, DK-2100 Copenhagen, Denmark; Department of Gynaecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
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141
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Skoulakis A, Fountas S, Mantzana-Peteinelli M, Pantelidi K, Petinaki E. Prevalence of human papillomavirus and subtype distribution in male partners of women with cervical intraepithelial neoplasia (CIN): a systematic review. BMC Infect Dis 2019; 19:192. [PMID: 30808285 PMCID: PMC6390310 DOI: 10.1186/s12879-019-3805-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 02/11/2019] [Indexed: 02/02/2023] Open
Abstract
Background Human Papillomavirus (HPV) infection is estimated to be the most common sexually transmitted infection. The present systematic review summarizes data regarding the prevalence of HPV and the distribution of subtypes in heterosexual male partners of women, who were diagnosed with any grade of cervical intraepithelial neoplasia (CIN). Methods We conducted a systematic review of the literature by Medline and Google Scholar databases using the terms “Human Papillomavirus” or “HPV” plus “men” or “male partners” or “women with CIN”. We included original published English-language articles published from 1/1/2000 until 1/1/2018 that had screened male partners of women with CIN using HPV DNA testing. We excluded studies that they overlapped with other included studies or were unrelated to the study subject. Results We included a total of 12 publications, which reported the prevalence of HPV in free-clinical signs male partners of women with CIN. The largest proportion of the studies were from South America (seven studies), and the rest from Europe. The mean age of participants was 35.18 + − 3.47 years. HPV prevalence ranged from 12.9 to 86%; the total HPV prevalence among the studies was 49.1%, while ten out twelve studies (83.3%) demonstrated prevalence > 20%. Between the studies, the distribution of HPV subtypes varied on the basis of the method used, on the population and on the geographic region. A great variety of subtypes were detected, including 6, 11, 16, 18, 31, 33, 40, 42, 45, 51, 52, 53, 54, 56, 57, 58, 59, 61, 62, 66, 68, 81 and 83. In six studies the HPV 16 was the most frequent, while in two others the HPV 6 and HPV 83. Conclusions Until now, there are not precise screening or surveillance guidelines for the management of partners of women with CIN. This population is frequently colonized by various HPV subtypes and therefore need to be screened in an effort to reduce the infection in both sexes. The screening test could include detection/identification of HPV subtypes by a molecular assay, followed by peniscopy only in the positive cases.
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Affiliation(s)
- Anargyros Skoulakis
- Department of Microbiology, Medical School, University of Thessaly, Larissa, Greece
| | - Serafim Fountas
- Department of Microbiology, Medical School, University of Thessaly, Larissa, Greece
| | | | - Kleoniki Pantelidi
- Department of Microbiology, Medical School, University of Thessaly, Larissa, Greece
| | - Efthymia Petinaki
- Department of Microbiology, Medical School, University of Thessaly, Larissa, Greece.
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