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Trias I, Algaba F, de Torres I, Saco A, Marimon L, Peñuelas N, Diez-Ahijado L, Sisuashvili L, Darecka K, Morató A, Del Pino M, Ferrándiz-Pulido C, Ribal MJ, Ajami T, Corral JM, Gaya JM, Reig O, Ordi O, Ribera-Cortada I, García-Herrera A, Rakislova N. p53 Immunohistochemistry Defines a Subset of Human Papillomavirus-Independent Penile Squamous Cell Carcinomas With Adverse Prognosis. Am J Surg Pathol 2024:00000478-990000000-00398. [PMID: 39040011 DOI: 10.1097/pas.0000000000002291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
Penile squamous cell carcinoma (PSCC) is classified into 2 prognostically distinct types: human papillomavirus (HPV)-associated and HPV-independent. However, the impact of p53 status on prognosis remains controversial. We correlated HPV and p53 status with the prognosis of a large series of patients with PSCC. p53 was analyzed according to a recently described immunohistochemical (IHC) pattern-based framework that includes 2 normal and 4 abnormal patterns and closely correlates with TP53 mutational status. A total of 122 patients with surgically treated PSCC in 3 hospitals were included. Based on HPV in situ hybridization and p16 and p53 IHC, the tumors were classified into 3 subtypes: HPV-associated, HPV-independent/p53 normal, and HPV-independent/p53 abnormal. All patients were followed up for at least 22 months (median: 56.9 months). Thirty-six tumors (29%) were HPV-associated, 35 (29%) were HPV-independent/p53 normal, and 51 (42%) were HPV-independent/p53 abnormal. Disease-related deaths were observed in 3/36 (8%), 0/35 (0%) and 14/51 (27%) of the patients, respectively (P< 0.001). A total of 7/14 deaths in the latter group were patients with tumors showing p53 abnormal patterns not recognized in the classic p53 IHC interpretation (basal, null, and cytoplasmic). According to our multivariate analysis, HPV-independent/p53 abnormal tumors and advanced stage were associated with impaired disease-specific survival (hazard ratio = 23.4, 95% CI = 2.7-3095.3; P= 0.001 and 16.3, 95% CI = 1.8-2151.5; P= 0.008, respectively). In conclusion, compared with patients with HPV-associated and HPV-independent/p53-normal PSCC, patients with HPV-independent/p53 abnormal PSCC have worse clinical outcomes. p53 IHC results define 2 prognostic categories in HPV-independent PSCC: HPV-independent/p53-normal tumors as low-risk tumors, whereas HPV-independent/p53-abnormal tumors as aggressive neoplasms.
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Affiliation(s)
- Isabel Trias
- Department of Pathology, Hospital Clinic of Barcelona-University of Barcelona, Barcelona, Spain
| | - Ferran Algaba
- Department of Pathology, Fundació Puigvert-Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Inés de Torres
- Department of Pathology, Hospital Universitari Vall d'Hebron-Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Adela Saco
- Department of Pathology, Hospital Clinic of Barcelona-University of Barcelona, Barcelona, Spain
- Medicine and Health Sciences Faculty (Facultat de Medicina i Ciències de la Salut)-University of Barcelona, Barcelona, Spain
| | - Lorena Marimon
- Department of Pathology, Hospital Clinic of Barcelona-University of Barcelona, Barcelona, Spain
- Barcelona Institute for Global Health (ISGlobal)-University of Barcelona, Barcelona, Spain
| | - Núria Peñuelas
- Barcelona Institute for Global Health (ISGlobal)-University of Barcelona, Barcelona, Spain
| | - Laia Diez-Ahijado
- Barcelona Institute for Global Health (ISGlobal)-University of Barcelona, Barcelona, Spain
| | - Lia Sisuashvili
- Department of Pathology, Hospital Clinic of Barcelona-University of Barcelona, Barcelona, Spain
| | - Katarzyna Darecka
- Department of Pathology, Hospital Clinic of Barcelona-University of Barcelona, Barcelona, Spain
| | - Alba Morató
- Medicine and Health Sciences Faculty (Facultat de Medicina i Ciències de la Salut)-University of Barcelona, Barcelona, Spain
- Barcelona Institute for Global Health (ISGlobal)-University of Barcelona, Barcelona, Spain
| | - Marta Del Pino
- Medicine and Health Sciences Faculty (Facultat de Medicina i Ciències de la Salut)-University of Barcelona, Barcelona, Spain
- Department of Obstetrics and Gynecology, Hospital Clínic of Barcelona-University of Barcelona
| | - Carla Ferrándiz-Pulido
- Department of Dermatology, Hospital Universitari Vall d'Hebron-Universitat Autònoma de Barcelona
| | - María José Ribal
- Uro-Oncology Unit, Hospital Clínic de Barcelona-University of Barcelona
| | - Tarek Ajami
- Uro-Oncology Unit, Hospital Clínic de Barcelona-University of Barcelona
| | | | - Josep Maria Gaya
- Department of Urology, Fundació Puigvert-Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Oscar Reig
- Translational Genomic and Targeted Therapeutics in Solid Tumors, Oncology and Haematology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medical Oncology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Oriol Ordi
- Medicine and Health Sciences Faculty (Facultat de Medicina i Ciències de la Salut)-University of Barcelona, Barcelona, Spain
- Barcelona Institute for Global Health (ISGlobal)-University of Barcelona, Barcelona, Spain
| | | | - Adriana García-Herrera
- Department of Pathology, Hospital Clinic of Barcelona-University of Barcelona, Barcelona, Spain
- Medicine and Health Sciences Faculty (Facultat de Medicina i Ciències de la Salut)-University of Barcelona, Barcelona, Spain
| | - Natalia Rakislova
- Department of Pathology, Hospital Clinic of Barcelona-University of Barcelona, Barcelona, Spain
- Medicine and Health Sciences Faculty (Facultat de Medicina i Ciències de la Salut)-University of Barcelona, Barcelona, Spain
- Barcelona Institute for Global Health (ISGlobal)-University of Barcelona, Barcelona, Spain
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2
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Hrudka J, Hojný J, Prouzová Z, Kendall Bártů M, Čapka D, Zavillová N, Matěj R, Waldauf P. High tumour mutational burden is associated with strong PD-L1 expression, HPV negativity, and worse survival in penile squamous cell carcinoma: an analysis of 165 cases. Pathology 2024; 56:357-366. [PMID: 38161143 DOI: 10.1016/j.pathol.2023.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/26/2023] [Accepted: 10/15/2023] [Indexed: 01/03/2024]
Abstract
Penile squamous cell carcinoma (pSCC) is a rare tumour with a variable prognosis. More prognostic markers linked to mutational signatures and the tumour immune microenvironment are needed. A cohort made up of 165 invasive pSCC was retrospectively analysed using formalin-fixed, paraffin-embedded tumour tissue, focusing on tumour mutational burden (TMB), programmed death ligand 1 (PD-L1) expression, microsatellite instability (MSI), the number of tumour infiltrating lymphocytes (TILs) expressing cytotoxic T-lymphocyte-associated protein 4 (CTLA4), HPV status determined by p16 immunohistochemistry, and several traditional histopathological variables. High TMB (>10 mut/Mb) was associated with high PD-L1 expression (TPS 50-100%), and HPV-negative status. High PD-L1 expression was linked to HPV negativity, a high number of intratumoural CTLA4+ cells, and brisk lymphocytic infiltrate. High TMB was a significant predictor of shorter overall survival (OS) in both univariate and multivariate analysis when using a median cut-off value of 4.3 mut/Mb, but not when using an arbitrary cut-off of 10 mut/Mb. Low CTLA4+ cell infiltration at the tumour invasion front was a marker of shorter OS and cancer-specific survival in both univariate and multivariate analysis. PD-L1 expression had no significant impact on prognosis. Only two cases were MSI high. The results support the hypothesis of two aetiological pathways in pSCC cancerogenesis: (1) SCC linked to HPV infection characterised by low TMB, less common PD-L1 expression, and a lower number of TILs; and (2) SCC linked to chronic inflammation leading to a high number of acquired mutations (high TMB), HPV negativity, increased neoantigen production (i.e., PD-L1), and high immune cell infiltration.
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Affiliation(s)
- Jan Hrudka
- Department of Pathology, 3rd Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic.
| | - Jan Hojný
- Department of Pathology, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic
| | - Zuzana Prouzová
- Department of Pathology, 3rd Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic; Department of Pathology, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic
| | - Michaela Kendall Bártů
- Department of Pathology, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic
| | - David Čapka
- Department of Urology, 3rd Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - Nicolette Zavillová
- Department of Urology, 3rd Faculty of Medicine of Charles University, Thomayer University Hospital, Prague, Czech Republic
| | - Radoslav Matěj
- Department of Pathology, 3rd Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic; Department of Pathology, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic; Department of Pathology and Molecular Medicine, 3rd Faculty of Medicine, Charles University, Thomayer University Hospital, Prague, Czech Republic
| | - Petr Waldauf
- Department of Anaesthesia and Intensive Care Medicine, 3rd Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic
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Ionescu F, Nguyen J, Segura CM, Paravathaneni M, Grass GD, Johnstone P, Zacharias NM, Pettaway CA, Lu X, Kim Y, Whiting J, Dhillon J, Eschrich SA, Chadha J, Gullapalli K, Roman Souza G, Miyagi H, Manley BJ, Spiess PE, Chahoud J. Multiplex Immunofluorescence Captures Progressive Immune Exhaustion with Advancing Penile Squamous Cell Cancer Stage. Cancers (Basel) 2024; 16:303. [PMID: 38275860 PMCID: PMC10814242 DOI: 10.3390/cancers16020303] [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: 12/04/2023] [Revised: 12/25/2023] [Accepted: 01/05/2024] [Indexed: 01/27/2024] Open
Abstract
Penile squamous cell carcinoma (PSCC) is a rare and deadly malignancy. Therapeutic advances have been stifled by a poor understanding of disease biology. Specifically, the immune microenvironment is an underexplored component in PSCC and the activity of immune checkpoint inhibitors observed in a subset of patients suggests immune escape may play an important role in tumorigenesis. Herein, we explored for the first time the immune microenvironment of 57 men with PSCC and how it varies with the presence of human papillomavirus (HPV) infection and across tumor stages using multiplex immunofluorescence of key immune cell markers. We observed an increase in the density of immune effector cells in node-negative tumors and a progressive rise in inhibitory immune players such as type 2 macrophages and upregulation of the PD-L1 checkpoint in men with N1 and N2-3 disease. There were no differences in immune cell densities with HPV status.
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Affiliation(s)
- Filip Ionescu
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA; (F.I.); (M.P.); (J.C.); (P.E.S.)
| | - Jonathan Nguyen
- Pathology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA
| | | | - Mahati Paravathaneni
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA; (F.I.); (M.P.); (J.C.); (P.E.S.)
| | - G. Daniel Grass
- Radiation Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Peter Johnstone
- Radiation Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Niki M. Zacharias
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Curtis A. Pettaway
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Xin Lu
- Department of Biological Sciences, University of Notre Dame, Norte Dame, IN 46556, USA;
| | - Youngchul Kim
- Biostatistics and Bioinformatics Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Junmin Whiting
- Biostatistics and Bioinformatics Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Jasreman Dhillon
- Pathology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Steven A. Eschrich
- Biostatistics and Bioinformatics Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Juskaran Chadha
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA; (F.I.); (M.P.); (J.C.); (P.E.S.)
| | - Keerthi Gullapalli
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA; (F.I.); (M.P.); (J.C.); (P.E.S.)
| | - Gabriel Roman Souza
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA; (F.I.); (M.P.); (J.C.); (P.E.S.)
| | - Hiroko Miyagi
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA; (F.I.); (M.P.); (J.C.); (P.E.S.)
| | - Brandon J. Manley
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA; (F.I.); (M.P.); (J.C.); (P.E.S.)
| | - Philippe E. Spiess
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA; (F.I.); (M.P.); (J.C.); (P.E.S.)
| | - Jad Chahoud
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA; (F.I.); (M.P.); (J.C.); (P.E.S.)
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4
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Campos MAG, Teixeira AAL, Calixto JDRR, Larges JS, Pinho JD, Silva GEB. Predictive histopathological factors of nodal metastasis in penile cancer. Int Braz J Urol 2023; 49:628-636. [PMID: 37351908 PMCID: PMC10482464 DOI: 10.1590/s1677-5538.ibju.2022.0640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 05/11/2023] [Indexed: 06/24/2023] Open
Affiliation(s)
- Marcos Adriano Garcia Campos
- Universidade Estadual PaulistaFaculdade de MedicinaBotucatuSPBrasilFaculdade de Medicina da Universidade Estadual Paulista - Unesp, Botucatu, SP, Brasil
| | - Antonio Augusto Lima Teixeira
- Hospital Universitário Presidente DutraLaboratório de Imunofluorescência e Microscopia EletrônicaSão LuísMABrasilLaboratório de Imunofluorescência e Microscopia Eletrônica, Hospital Universitário Presidente Dutra, São Luís, MA, Brasil
- Universidade de São PauloDepartamento de GenéticaRibeirão PretoSPBrasilDepartamento de Genética, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - José de Ribamar Rodrigues Calixto
- Universidade Federal do MaranhãoDepartamento de Medicina IISão LuísMABrasilDepartamento de Medicina II, Universidade Federal do Maranhão, São Luís, MA, Brasil
| | - Joyce Santos Larges
- Hospital Universitário Presidente DutraLaboratório de Imunofluorescência e Microscopia EletrônicaSão LuísMABrasilLaboratório de Imunofluorescência e Microscopia Eletrônica, Hospital Universitário Presidente Dutra, São Luís, MA, Brasil
| | - Jaqueline Diniz Pinho
- Hospital Universitário Presidente DutraLaboratório de Imunofluorescência e Microscopia EletrônicaSão LuísMABrasilLaboratório de Imunofluorescência e Microscopia Eletrônica, Hospital Universitário Presidente Dutra, São Luís, MA, Brasil
- Universidade Estadual do MaranhãoZé DocaMABrasilUniversidade Estadual do Maranhão, Zé Doca, MA, Brasil
| | - Gyl Eanes Barros Silva
- Hospital Universitário Presidente DutraLaboratório de Imunofluorescência e Microscopia EletrônicaSão LuísMABrasilLaboratório de Imunofluorescência e Microscopia Eletrônica, Hospital Universitário Presidente Dutra, São Luís, MA, Brasil
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Hakenberg O, Dräger DL. [Systemic treatment of penile cancer: New concepts? New achievements?]. Aktuelle Urol 2023; 54:304-312. [PMID: 37541237 DOI: 10.1055/a-2104-1418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2023]
Abstract
Systemic chemotherapy has been in use for metastatic penile carcinoma for years, but its success is limited. Its significance is largely associated with its role in multimodal treatment for lymphatic metastasis in the context of radical lymph node surgery. In cases of limited lymph node involvement, the combination of surgical treatment plus cisplatin- and taxane-based triple combinations may be curative. Advances in the understanding of molecular changes in penile cancer and the search for potential therapy targets have led to numerous studies. Although there is evidence of efficacy of immunotherapeutics, no significant therapeutic improvements have been seen in the clinical routine.
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6
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Parza K, Mustasam A, Ionescu F, Paravathaneni M, Sandstrom R, Safa H, Grass GD, Johnstone PA, Eschrich SA, Chadha J, Zacharias N, Pettaway CA, Spiess PE, Chahoud J. The Prognostic Role of Human Papillomavirus and p16 Status in Penile Squamous Cell Carcinoma-A Systematic Review. Cancers (Basel) 2023; 15:3713. [PMID: 37509374 PMCID: PMC10378259 DOI: 10.3390/cancers15143713] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/11/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
PSCC is a rare cancer, with approximately half of all cases related to HPV. While HPV and p16 IHC testing have proven their prognostic value for oropharyngeal cancer, this is not yet established for PSCC. The current level of evidence exploring the relation between PSCC and HPV is moderate, so we conducted a systematic review following PRISMA guidelines to evaluate the prognostic role of HPV and p16 IHC in PSCC clinical outcomes. We searched the PubMed, Embase, and Cochrane databases and identified 34 relevant studies that met our inclusion criteria. Of these, 33 were retrospective cohort studies, and one was a cross-sectional study. Nine studies reported that HPV-positive and p16-positive PSCC had better overall survival (OS) and disease-free survival (DFS). This study highlights the need for a meta-analysis to determine the role of routine HPV status or p16 staining testing as part of the initial diagnosis and staging of PSCC patients worldwide.
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Affiliation(s)
- Kevin Parza
- Internal Medicine, USF Health Morsani College of Medicine, Tampa, FL 33601, USA
| | - Arfa Mustasam
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33601, USA
| | - Filip Ionescu
- Internal Medicine, USF Health Morsani College of Medicine, Tampa, FL 33601, USA
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33601, USA
| | - Mahati Paravathaneni
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33601, USA
| | - Reagan Sandstrom
- Graduate Medication Education, USF Health Morsani College of Medicine, Tampa, FL 33602, USA
| | - Houssein Safa
- Hematology Oncology Department, Baylor College of Medicine, Houston, TX 77001, USA
| | - G Daniel Grass
- Radiation Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33601, USA
| | - Peter A Johnstone
- Radiation Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33601, USA
| | - Steven A Eschrich
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33601, USA
| | - Juskaran Chadha
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33601, USA
| | - Niki Zacharias
- Department of Urology, M.D. Anderson Cancer Center, University of Texas, Houston, TX 77001, USA
| | - Curtis A Pettaway
- Department of Urology, M.D. Anderson Cancer Center, University of Texas, Houston, TX 77001, USA
| | - Philippe E Spiess
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33601, USA
| | - Jad Chahoud
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33601, USA
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Hrudka J, Prouzová Z, Kendall Bártů M, Hojný J, Čapka D, Zavillová N, Matěj R, Waldauf P. Immune cell infiltration, tumour budding, and the p53 expression pattern are important predictors in penile squamous cell carcinoma: a retrospective study of 152 cases. Pathology 2023:S0031-3025(23)00124-1. [PMID: 37316384 DOI: 10.1016/j.pathol.2023.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 03/12/2023] [Accepted: 03/28/2023] [Indexed: 06/16/2023]
Abstract
Penile squamous cell carcinoma (pSCC) is a rare malignancy with a slowly increasing incidence and variable prognosis. Regional lymph node involvement signifies poor prognosis but represents a late sign, and more prognostic markers for effective patient risk stratification are urgently needed. In this retrospective study, 152 tumour samples with formalin-fixed, paraffin-embedded tissue were analysed for traditional pathological variables, tumour budding, p53, p16, and mismatch repair proteins (MMR) immunohistochemistry. The density of tumour lymphocytic infiltrate was also determined, using subjective evaluation by two pathologists (brisk/non-brisk/absent) and also using the immunoscore method, which categorised the cohort into five immunoscore groups according to the number of CD3+ and CD8+ T-cells in both the tumour centre and tumour invasion front. Only one case (0.6%) was MMR-deficient. Tumour budding count ≥5 tumour buds/20× power field and non-brisk/absent lymphocytic infiltrate were significant negative predictors of both the overall survival (OS) and cancer-specific survival (CSS), whereas a low immunoscore was a significant marker of shorter OS but not CSS. Advanced pT stage (3+4) was a significant marker of shorter CSS but not OS. In the multivariate analysis, high-grade budding was a significant parameter if adjusted for the patient's age and associated variables, except for the pN stage. The lymphocytic infiltrate retained its prognostic significance if adjusted for age and associated variables. The negative prognostic significance of the previously described parameters (lymphatic, venous, and perineural invasion, regional lymph node metastasis, and p53 mutated profile) were confirmed in our study. Grade, histological subtype, and HPV status (as determined by p16 immunohistochemistry) showed, surprisingly, little or no prognostic significance.
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Affiliation(s)
- Jan Hrudka
- Department of Pathology, 3rd Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic.
| | - Zuzana Prouzová
- Department of Pathology, 3rd Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic; Department of Pathology, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic
| | - Michaela Kendall Bártů
- Department of Pathology, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic
| | - Jan Hojný
- Department of Pathology, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic
| | - David Čapka
- Department of Urology, 3rd Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - Nicolette Zavillová
- Department of Urology, 3rd Faculty of Medicine of Charles University, Thomayer University Hospital, Prague, Czech Republic
| | - Radoslav Matěj
- Department of Pathology, 3rd Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic; Department of Pathology, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic; Department of Pathology and Molecular Medicine, 3rd Faculty of Medicine, Charles University, Thomayer University Hospital, Prague, Czech Republic
| | - Petr Waldauf
- Department of Anaesthesia and Intensive Care Medicine, 3rd Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic
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8
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Trias I, Saco A, Marimon L, López Del Campo R, Manzotti C, Ordi O, Del Pino M, Pérez FM, Vega N, Alós S, Martínez A, Rodriguez-Carunchio L, Reig O, Jares P, Teixido C, Ajami T, Corral-Molina JM, Algaba F, Ribal MJ, Ribera-Cortada I, Rakislova N. P53 in Penile Squamous Cell Carcinoma: A Pattern-Based Immunohistochemical Framework with Molecular Correlation. Cancers (Basel) 2023; 15:2719. [PMID: 37345055 DOI: 10.3390/cancers15102719] [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: 03/27/2023] [Revised: 05/02/2023] [Accepted: 05/07/2023] [Indexed: 06/23/2023] Open
Abstract
p53 immunohistochemistry (IHC) has been proposed as a surrogate for TP53 mutations in penile squamous cell carcinomas (PSCC). We aimed to evaluate the performance of a pattern-based evaluation of p53 IHC in PSCC. Human papilloma virus (HPV) DNA testing, p16 and p53 IHC, and whole exome sequencing were performed in a series of 40 PSCC. p53 IHC was evaluated following a pattern-based framework and conventional p53 IHC evaluation. Out of 40 PSCC, 12 (30.0%) were HPV-associated, and 28 (70.0%) were HPV-independent. The agreement between the p53 IHC pattern-based evaluation and TP53 mutational status was almost perfect (k = 0.85). The sensitivity and accuracy of the pattern-based framework for identifying TP53 mutations were 95.5% and 92.5%, respectively, which were higher than the values of conventional p53 IHC interpretation (54.5% and 70.0%, respectively), whereas the specificity was the same (88.9%). In conclusions, the pattern-based framework improves the accuracy of detecting TP53 mutations in PSCC compared to the classical p53 IHC evaluation.
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Affiliation(s)
- Isabel Trias
- Department of Pathology, Hospital Clínic of Barcelona, University of Barcelona, 08036 Barcelona, Spain
| | - Adela Saco
- Department of Pathology, Hospital Clínic of Barcelona, University of Barcelona, 08036 Barcelona, Spain
| | - Lorena Marimon
- Department of Pathology, Hospital Clínic of Barcelona, University of Barcelona, 08036 Barcelona, Spain
- Barcelona Institute of Global Health (ISGlobal), University of Barcelona, 08036 Barcelona, Spain
| | - Ricardo López Del Campo
- Department of Pathology, Hospital Clínic of Barcelona, University of Barcelona, 08036 Barcelona, Spain
| | - Carolina Manzotti
- Department of Pathology, Hospital Clínic of Barcelona, University of Barcelona, 08036 Barcelona, Spain
- Barcelona Institute of Global Health (ISGlobal), University of Barcelona, 08036 Barcelona, Spain
| | - Oriol Ordi
- Barcelona Institute of Global Health (ISGlobal), University of Barcelona, 08036 Barcelona, Spain
| | - Marta Del Pino
- Department of Obstetrics and Gynecology, Hospital Clínic of Barcelona, Universityof Barcelona, 08036 Barcelona, Spain
| | - Francisco M Pérez
- Department of Pathology, Hospital Clínic of Barcelona, University of Barcelona, 08036 Barcelona, Spain
| | - Naiara Vega
- Department of Pathology, Hospital Clínic of Barcelona, University of Barcelona, 08036 Barcelona, Spain
| | - Silvia Alós
- Department of Pathology, Hospital Clínic of Barcelona, University of Barcelona, 08036 Barcelona, Spain
| | - Antonio Martínez
- Department of Pathology, Hospital Clínic of Barcelona, University of Barcelona, 08036 Barcelona, Spain
| | - Leonardo Rodriguez-Carunchio
- Department of Pathology, Hospital Clínic of Barcelona, University of Barcelona, 08036 Barcelona, Spain
- Faculty of Medicine, University of Vic-Central University of Catalonia (UVic-UCC), 08500 Vic, Spain
| | - Oscar Reig
- Translational Genomic and Targeted Therapeutics in Solid Tumors, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
- Department of Medical Oncology, Hospital Clínic of Barcelona, 08036 Barcelona, Spain
| | - Pedro Jares
- Department of Pathology, Hospital Clínic of Barcelona, University of Barcelona, 08036 Barcelona, Spain
| | - Cristina Teixido
- Department of Pathology, Hospital Clínic of Barcelona, University of Barcelona, 08036 Barcelona, Spain
- Translational Genomic and Targeted Therapeutics in Solid Tumors, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
| | - Tarek Ajami
- Uro-Oncology Unit, Hospital Clínic of Barcelona, University of Barcelona, 08036 Barcelona, Spain
| | | | - Ferran Algaba
- Department of Pathology, Fundació Puigvert, Universitat Autònoma de Barcelona, 08025 Barcelona, Spain
| | - María J Ribal
- Uro-Oncology Unit, Hospital Clínic of Barcelona, University of Barcelona, 08036 Barcelona, Spain
| | - Inmaculada Ribera-Cortada
- Department of Pathology, Hospital Clínic of Barcelona, University of Barcelona, 08036 Barcelona, Spain
| | - Natalia Rakislova
- Department of Pathology, Hospital Clínic of Barcelona, University of Barcelona, 08036 Barcelona, Spain
- Barcelona Institute of Global Health (ISGlobal), University of Barcelona, 08036 Barcelona, Spain
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9
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Naushad N, Deb AA, Agag AA, Serag HA, Sangar VK. Prognostic Markers and Trials in Penile Cancer. UROLOGY RESEARCH & PRACTICE 2023; 49:138-146. [PMID: 37877863 PMCID: PMC10346112 DOI: 10.5152/tud.2023.22225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 01/03/2023] [Indexed: 10/26/2023]
Abstract
New tumor biomarkers open the potential for designing personalized therapy for penile squamous cell carcinoma. Despite the initial promising results of some biomarkers, controversy remains due to contradictory studies. Further robust research work is required before incorporating biomarkers in the personalized management of penile cancer. This narrative review aims to highlight some of the most commonly and recently investigated biomarkers of penile cancer and to summarize the ongoing registered clinical trials for the management of penile cancer patients.
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Affiliation(s)
- Naufal Naushad
- Department of Urology, Christie NHS Foundation Trust, Manchester, UK
| | - Abdalla A. Deb
- Department of Urology, James Cook University Hospital, Middlesbrough, UK
| | - Ayman A. Agag
- Department of Urology, Frimley Park Hospital, Frimley, UK
| | - Hosam A. Serag
- Department of Urology, University Hospitals Birmingham, Birmingham, UK
| | - Vijay K. Sangar
- Department of Urology, Christie NHS Foundation Trust, Manchester, UK
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10
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Spînu AD, Marcu DR, Amza RA, Iorga DL, Mischianu D, Costache RS, Costache DO, Constantin A. Clinical significance of p16INK4a and p53 and their involvement in penile cancer development. A literature review. ROMANIAN JOURNAL OF MILITARY MEDICINE 2022. [DOI: 10.55453/rjmm.2022.125.4.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
"Background: Human papillomavirus (HPV) E6 and E7 oncoproteins are vital for developing HPV induced penile carcinoma. The viral oncoproteins play a central role in oncogenesis by interacting with several cellular regulatory proteins, such as p16INK4a and p53. Many studies suggest that these proteins showed clinical utility in predicting nodal disease, cancer specific survival, overall survival and even tumor grade. Understanding the molecular mechanism involved in the carcinogenesis of penile cancer could offer biomarkers for disease progression, treatment response and potential targeted therapies; (2) Methods: This paper is a prospective study on a group of 100 patients who underwent prostate surgery during 2013 and 2014 in the Urology Clinic of “Carol Davila” Central Military Emergency University Hospital Bucharest. They were tested for HPV by PCR and IHC (p16) methods; (3) Results: 11 cases (22%) of HPV were found in the cluster of patients tested. PCR and P16 were the HPV diagnostic tests used. In order to determine the consistency of the 2 tests, the Cohen’s kappa coefficient was used at a p level < 0.05. The PCR method had a sensitivity of 81.8% and a specificity of 94.9%. The P16 method had a sensitivity of 63.6% and a specificity of 89.7%."
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11
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Teixeira Júnior AAL, da Costa Melo SP, Pinho JD, Sobrinho TBM, Rocha TMS, Duarte DRD, de Oliveira Barbosa L, Duarte WE, de Castro Belfort MR, Duarte KG, da Silva Neto AL, de Ribamar Rodrigues Calixto J, Paiva Paiva LC, do Nascimento FSMS, Alencar Junior AM, Khayat AS, da Graça Carvalhal Frazão Corrêa R, Lages JS, Dos Reis RB, Araújo WS, Silva GEB. A comprehensive analysis of penile cancer in the region with the highest worldwide incidence reveals new insights into the disease. BMC Cancer 2022; 22:1063. [PMID: 36243680 PMCID: PMC9569053 DOI: 10.1186/s12885-022-10127-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 09/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although penile cancer (PC) is uncommon in developed countries, it is widespread in developing countries. The state of Maranhão (Northeast, Brazil) has the highest global incidence recorded for PC, and, despite its socioeconomic vulnerability, it has been attributed to human papillomavirus (HPV) infection. This study aimed to determine the histopathological features, the prevalence of HPV infection, and the immunohistochemical profile of PC in Maranhão. METHODS A retrospective cohort of 200 PC cases were evaluated. HPV detection was performed using nested-PCR followed by direct sequencing for genotyping. Immunohistochemistry (IHC) was performed using monoclonal antibodies anti-p16INK4a, p53, and ki-67. RESULTS Our data revealed a delay of 17 months in diagnosis, a high rate of penile amputation (96.5%), and HPV infection (80.5%) in patients from Maranhão (Molecular detection). We demonstrated the high rate of HPV in PC also by histopathological and IHC analysis. Most patients presented koilocytosis (75.5%), which was associated with those reporting more than 10 different sexual partners during their lifetime (p = 0.001). IHC revealed frequent p16INK4a overexpression (26.0%) associated with basaloid (p < 0.001) and high-grade tumors (p = 0.008). Interestingly, p16 appears not to be a better prognostic factor in our disease-free survival analysis, as previously reported. We also demonstrated high ki-67 and p53 expression in a subset of cases, which was related to worse prognostic factors such as high-grade tumors, angiolymphatic and perineural invasion, and lymph node metastasis. We found a significant impact of high ki-67 (p = 0.002, log-rank) and p53 (p = 0.032, log-rank) expression on decreasing patients' survival, as well as grade, pT, stage, pattern, and depth of invasion (p < 0.05, log-rank). CONCLUSIONS Our data reaffirmed the high incidence of HPV infection in PC cases from Maranhão and offer new insights into potential factors that may contribute to the high PC incidence in the region. We highlighted the possible association of HPV with worse clinical prognosis factors, differently from what was observed in other regions. Furthermore, our IHC analysis reinforces p16, ki-67, and p53 expression as important diagnosis and/or prognosis biomarkers, potentially used in the clinical setting in emerging countries such as Brazil.
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Affiliation(s)
- Antonio Augusto Lima Teixeira Júnior
- Department of Genetics and Postgraduate Program in Genetics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.,Postgraduate Program in Adult Health, Federal University of Maranhão, São Luís, Brazil
| | - Syomara Pereira da Costa Melo
- Laboratory of Immunofluorescence and Electron Microscopy, University Hospital of the Federal University of Maranhão, São Luís, Brazil
| | | | - Thaís Bastos Moraes Sobrinho
- Laboratory of Immunofluorescence and Electron Microscopy, University Hospital of the Federal University of Maranhão, São Luís, Brazil
| | - Thalita Moura Silva Rocha
- Postgraduate Program in Adult Health, Federal University of Maranhão, São Luís, Brazil.,Laboratory of Immunofluorescence and Electron Microscopy, University Hospital of the Federal University of Maranhão, São Luís, Brazil
| | - Denner Rodrigo Diniz Duarte
- Laboratory of Immunofluorescence and Electron Microscopy, University Hospital of the Federal University of Maranhão, São Luís, Brazil
| | - Liseana de Oliveira Barbosa
- Laboratory of Immunofluorescence and Electron Microscopy, University Hospital of the Federal University of Maranhão, São Luís, Brazil
| | - Wesliany Everton Duarte
- Postgraduate Program in Adult Health, Federal University of Maranhão, São Luís, Brazil.,Laboratory of Immunofluorescence and Electron Microscopy, University Hospital of the Federal University of Maranhão, São Luís, Brazil
| | - Marta Regina de Castro Belfort
- Laboratory of Immunofluorescence and Electron Microscopy, University Hospital of the Federal University of Maranhão, São Luís, Brazil.,Postgraduate Program in Health Science, Federal University of Maranhão, São Luís, Brazil
| | - Kelly Gomes Duarte
- Postgraduate Program in Clinical Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Antonio Lima da Silva Neto
- Laboratory of Immunofluorescence and Electron Microscopy, University Hospital of the Federal University of Maranhão, São Luís, Brazil
| | | | - Lúcio Cristiano Paiva Paiva
- Laboratory of Immunofluorescence and Electron Microscopy, University Hospital of the Federal University of Maranhão, São Luís, Brazil
| | | | - Antonio Machado Alencar Junior
- Postgraduate Program in Health Science, Federal University of Maranhão, São Luís, Brazil.,University Hospital of the Federal University of Maranhão, São Luís, Brazil
| | | | | | - Joyce Santos Lages
- University Hospital of the Federal University of Maranhão, São Luís, Brazil
| | - Rodolfo Borges Dos Reis
- Postgraduate Program in Clinical Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Wilson Silva Araújo
- Department of Genetics and Postgraduate Program in Genetics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Gyl Eanes Barros Silva
- Postgraduate Program in Adult Health, Federal University of Maranhão, São Luís, Brazil. .,Laboratory of Immunofluorescence and Electron Microscopy, University Hospital of the Federal University of Maranhão, São Luís, Brazil. .,Postgraduate Program in Health Science, Federal University of Maranhão, São Luís, Brazil.
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12
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Chaux A, Sanchez DF, Fernández-Nestosa MJ, Cañete-Portillo S, Rodríguez IM, Giannico GA, Cubilla AL. The dual pathogenesis of penile neoplasia: The heterogeneous morphology of human papillomavirus-related tumors. Asian J Urol 2022; 9:349-358. [DOI: 10.1016/j.ajur.2022.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/27/2022] [Accepted: 02/10/2022] [Indexed: 11/28/2022] Open
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13
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Bandini M, Ahmed M, Basile G, Watkin N, Master V, Zhu Y, Prakash G, Rodriguez A, Ssebakumba MK, Leni R, Cirulli GO, Ayres B, Compitello R, Pederzoli F, Joshi PM, Kulkarni SB, Montorsi F, Sonpavde G, Necchi A, Spiess PE. A global approach to improving penile cancer care. Nat Rev Urol 2022; 19:231-239. [PMID: 34937881 PMCID: PMC8693593 DOI: 10.1038/s41585-021-00557-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2021] [Indexed: 02/06/2023]
Abstract
Rare tumours such as penile carcinoma have been largely neglected by the urology scientific community in favour of more common - and, therefore, more easily fundable - diseases. Nevertheless, penile cancer represents a rising burden for health-care systems around the world, because a lack of widespread expertise, ineffective centralization of care and absence of research funds have hampered our ability to improve the global care of these patients. Moreover, a dichotomy has arisen in the field of penile cancer, further impeding care: the countries that are mainly supporting research on this topic through the development of epidemiological studies and design of clinical trials are not the countries that have the highest prevalence of the disease. This situation means that randomized controlled trials in developed countries often do not meet the minimum accrual and are intended to close before reaching their end points, whereas trials are almost completely absent in those areas with the highest disease prevalence and probability of successful recruitment, such as Africa, South America and South Asia. The scientific and organizational inaction that arises owing to this mismatch translates into a burdensome cost for our patients. A global effort to gather experts and pull together scientific data from around the world may be the best way to boost clinical research, to change clinical practice and, ultimately, to improve care for patients and their families.
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Affiliation(s)
- Marco Bandini
- Urological Research Institute (URI), IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy.
| | - Mohamed Ahmed
- grid.66875.3a0000 0004 0459 167XDepartment of Urology, Mayo Clinic, Rochester, MN USA
| | - Giuseppe Basile
- grid.15496.3f0000 0001 0439 0892Urological Research Institute (URI), IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Nicholas Watkin
- grid.451349.eSt George’s University Hospitals, NHS Foundation Trust, London, UK
| | - Viraj Master
- grid.189967.80000 0001 0941 6502Emory University School of Medicine, Department of Urology, Atlanta, GA USA
| | - Yao Zhu
- grid.452404.30000 0004 1808 0942Fudan University Shanghai Cancer Center, Shanghai, China
| | - Gagan Prakash
- grid.450257.10000 0004 1775 9822Department of Urosurgery, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Alejandro Rodriguez
- grid.416016.40000 0004 0456 3003Urology Associates of Rochester, Rochester General Hospital, Rochester, NY USA
| | | | - Riccardo Leni
- grid.15496.3f0000 0001 0439 0892Urological Research Institute (URI), IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Giuseppe Ottone Cirulli
- grid.15496.3f0000 0001 0439 0892Urological Research Institute (URI), IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Ben Ayres
- grid.451349.eSt George’s University Hospitals, NHS Foundation Trust, London, UK
| | - Rachel Compitello
- grid.468198.a0000 0000 9891 5233Moffitt Cancer Center and Research Institute, Tampa, FL USA
| | - Filippo Pederzoli
- grid.15496.3f0000 0001 0439 0892Urological Research Institute (URI), IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Pankaj M. Joshi
- grid.512719.9Kulkarni Reconstructive Urology Center, Pune, India
| | | | - Francesco Montorsi
- grid.15496.3f0000 0001 0439 0892Urological Research Institute (URI), IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Guru Sonpavde
- grid.38142.3c000000041936754XDana Farber Cancer Institute, Harvard Medical School, Boston, MA USA
| | - Andrea Necchi
- grid.15496.3f0000 0001 0439 0892Urological Research Institute (URI), IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Philippe E. Spiess
- grid.468198.a0000 0000 9891 5233Moffitt Cancer Center and Research Institute, Tampa, FL USA
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14
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Mohanty SK, Mishra SK, Bhardwaj N, Sardana R, Jaiswal S, Pattnaik N, Pradhan D, Sharma S, Kaushal S, Baisakh MR, Das S, Pradhan MR, Satapathy K, Pattnaik A, Sharma SK, Khadenga CR, Das S, Rath D, Nanda B, Parwani AV. p53 and p16 ink4a As Predictive and Prognostic Biomarkers for Nodal metastasis and Survival in A Contemporary Cohort of Penile Squamous Cell Carcinoma. Clin Genitourin Cancer 2021; 19:510-520. [PMID: 34348854 DOI: 10.1016/j.clgc.2021.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 05/30/2021] [Accepted: 07/02/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Human papilloma virus (HPV) infection is implicated in a proportion of invasive squamous cell carcinoma of the penis (PC). A subset of PC involves dysregulation of the p53 pathway. HPV in situ hybridization (ISH) and p16ink4a positivity are surrogate markers for HPV infection, and p53 immunohistochemistry (IHC) denotes abnormality in the p53 pathway. There remains an ambiguity with regard to the contribution of both the pathways in the prognosis of PC. We sought to analyze the clinicopathologic characteristics of a cohort of Indian PC patients with respect to p16 ink4a and p53 expression. PATIENTS AND METHODS A cohort of 123 PC patients was studied for p16ink4aand p53IHC and HPVISH. The results of these biomarkers were correlated with various clinicopathologic parameters. RESULTS p16ink4a and HPV ISH were positive in 47% and 53% of the tumors, respectively. The proportion of warty, basaloid, or mixed warty-basaloid tumor subtypes showed significant p16ink4apositivity (P < .0001) compared to other subtypes. Twenty-eight patients were dual negative (p53- /p16ink4a-), 32 were dual positive (p53+/p16ink4a+), 38 were p53+/p16ink4a-, and 25 were p53-/p16ink4a +. In patients where p16ink4a was negative, a p53-positive phenotype had a higher propensity for lymph node metastases (OR, 5.42; 95% CI, 1.75-16.80; P = .003). Similarly, p53 positivity dictates nodal involvement in the p16ink4a-positive subset of tumors (OR, 5.00; 95% CI, 1.23-20.17; P = .024). On multivariate analyses, pathologic subtypes (warty, warty-basaloid, and basaloid) (P < .0001), p16ink4aexpression (P < .0001), and absence of nodal metastasis (P < .0001) were significant predictors of improved overall (OS) and cancer specific survival (CSS). In Kaplan-Meier analysis, the OS was significantly longer in patients with p16ink4a + tumors (P < .0001), as was the CSS (P < .0001). Patients with dual positive tumors had a significantly higher OS (P < .001) and CSS (P = .012), in the entire cohort. In the node positive patients, dual positivity was associated with significantly higher OS (P < .0001); however, the median CSS for p53+/p16ink4a+tumors were not significantly different compared to p53- /p16ink4a- tumors (P = .064), although there was a trend towards improved CSS. CONCLUSIONS There is a strong concordance between p16ink4aIHC and HPV ISH results. p16ink4a status is an independent predictor of survival (OS and CSS) in our cohort of PCs. p53 is a predictor of nodal metastasis irrespective of p16 status. Dual positive tumors have a significantly better outcome in comparison to dual negative tumors.
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Affiliation(s)
- Sambit K Mohanty
- Department of Pathology and Laboratory Medicine, Advanced Medical Research Institute, Bhubaneswar, India; Department of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, India
| | - Sourav K Mishra
- Department of Medical Oncology, Advanced Medical Research Institute, Bhubaneswar, India
| | - Nitin Bhardwaj
- Department of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, India
| | - Ruhani Sardana
- Department of Pathology and Laboratory Medicine, Advanced Medical Research Institute, Bhubaneswar, India
| | - Sunil Jaiswal
- Department of Surgical Oncology, Advanced Medical Research Institute, Bhubaneswar, India
| | - Niharika Pattnaik
- Department of Pathology and Laboratory Medicine, Advanced Medical Research Institute, Bhubaneswar, India
| | | | - Shivani Sharma
- Department of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, India
| | - Seema Kaushal
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Manas R Baisakh
- Department of Pathology and Laboratory Medicine, Prolife Diagnostics, Bhubaneswar, India
| | - Suren Das
- Department of Urology, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, India
| | - Manas R Pradhan
- Department of Urology, Advanced Medical Research Institute, Bhubaneswar, India
| | | | - Ashis Pattnaik
- Department of Pathology and Laboratory Medicine, Advanced Medical Research Institute, Bhubaneswar, India
| | - Shailendra K Sharma
- Department of Pathology and Laboratory Medicine, Advanced Medical Research Institute, Bhubaneswar, India
| | - Chira R Khadenga
- Department of Radiation Oncology, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, India
| | - Subodh Das
- Department of Urology, Advanced Medical Research Institute, Bhubaneswar, India
| | - Debadarshi Rath
- Department of Urology, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, India
| | - Biswajit Nanda
- Department of Urology, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, India
| | - Anil V Parwani
- Department of Pathology, Wexner Medical Center, Columbus, OH.
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15
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Masterson TA, Tagawa ST. A 25-year perspective on advances in an understanding of the biology, evaluation, treatment and future directions/challenges of penile cancer. Urol Oncol 2021; 39:569-576. [PMID: 34219002 DOI: 10.1016/j.urolonc.2021.05.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 05/14/2021] [Accepted: 05/18/2021] [Indexed: 02/05/2023]
Abstract
Squamous cell carcinoma of the penis (SCCP) is uncommon in some countries (including the U.S.), but is an important malignancy elsewhere. As a rare disease, progress has been slow compared to more common tumor types discussed in this anniversary issue and most often limited to single-center or retrospective datasets. In this section we describe developments leading to the current standard approach with current research questions.
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Affiliation(s)
- Timothy A Masterson
- Department of Urology, Indiana University School of Medicine, Indianapolis, IN
| | - Scott T Tagawa
- Division of Hematology & Medical Oncology, Department of Medicine and Department of Urology, Weill Cornell Medicine, New York, NY.
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16
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Compérat E, Moguelet P. [Lesions of the penis, the anatomy, epidemiology and carcinogenesis]. Ann Pathol 2021; 42:2-4. [PMID: 33820663 DOI: 10.1016/j.annpat.2021.03.002] [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: 11/20/2020] [Revised: 03/03/2021] [Accepted: 03/04/2021] [Indexed: 11/30/2022]
Abstract
The penile carcinoma is rare, but many items playing a role are complex and it is important to know as well the anatomy, but also the carcinogenesis for a perfect patient's management.
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Affiliation(s)
- Eva Compérat
- Service d'anatomie et cytologie pathologiques, Sorbonne université, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France.
| | - Philippe Moguelet
- Service d'anatomie et cytologie pathologiques, Sorbonne université, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
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17
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Zito Marino F, Sabetta R, Pagliuca F, Brunelli M, Aquino G, Perdonà S, Botti G, Facchini G, Fiorentino F, Di Lauro G, De Sio M, De Vita F, Toni G, Borges Dos Reis R, Neder L, Franco R. Discrepancy of p16 immunohistochemical expression and HPV RNA in penile cancer. A multiplex in situ hybridization/immunohistochemistry approach study. Infect Agent Cancer 2021; 16:22. [PMID: 33789689 PMCID: PMC8011184 DOI: 10.1186/s13027-021-00361-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 03/19/2021] [Indexed: 11/30/2022] Open
Abstract
Background The high-risk human papillomavirus (HPV) infection represents one of the main etiologic pathways of penile carcinogenesis in approximately 30–50 % of cases. Several techniques for the detection of HPV are currently available including Polymerase chain reaction-based techniques, DNA and RNA in situ hybridization (ISH), p16 immunohistochemistry (IHC). The multiplex HPV RNA ISH/p16 IHC is a novel technique for the simultaneous detection of HPV E6/E7 transcripts and p16INK4a overexpression on the same slide in a single assay. The main aim of this study was to evaluate the discrepancy of p16 IHC expression relatively to HPV RNA ISH in penile cancer tissue. Methods We collected a series of 60 PCs. HPV has been analysed through the RNA ISH, p16 IHC and the multiplex HPV RNA ISH/p16 IHC. Results The multiplex HPV RNA ISH /p16 IHC results in the series were in complete agreement with the previous results obtained through the classic p16 IHC and HPV RNA scope carried out on two different slides. The multiplex HPV RNA ISH /p16 IHC showed that HPV positivity in our series is more frequently in usual squamous cell carcinoma than in special histotypes (19 out of 60 − 15 %- versus 6 out of 60 − 10 %-), in high-grade than in moderate/low grade carcinomas (6 out of 60 − 10 %- versus 4 out of 60 − 6.7 %-). In addition, our data revealed that in 5 out of 20 cases with p16 high intensity expression is not associated with HPV RNA ISH positivity. Conclusions Our findings emphasize that the use of p16 as a surrogate of HPV positivity was unsuccessful in approximatively 8 % of cases analysed in our series. Indeed, p16 IHC showed a sensitivity of 100 % and a specificity of 71 %, with a positive predictive value (PPV) of 54 % and a negative predictive value of 100 %; when considering high intensity, p16 IHC showed a sensitivity of 100 %, a specificity of 89 %, with a PPV of 75 % and NPV of 100 %. Since HPV positivity could represent a relevant prognostic and predictive value, the correct characterization offered by this approach appears to be of paramount importance.
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Affiliation(s)
- Federica Zito Marino
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "L. Vanvitelli", Complesso di Santa Patrizia, Via Luciano Armanni, 5, 80138, Naples, Italy
| | - Rosalaura Sabetta
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "L. Vanvitelli", Complesso di Santa Patrizia, Via Luciano Armanni, 5, 80138, Naples, Italy
| | - Francesca Pagliuca
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "L. Vanvitelli", Complesso di Santa Patrizia, Via Luciano Armanni, 5, 80138, Naples, Italy
| | - Matteo Brunelli
- Department of Pathology, University of Verona, Verona, Italy
| | - Gabriella Aquino
- Pathology Unit, Istituto Nazionale Tumori, Fondazione G. Pascale, IRCCS, 80131, Naples, Italy
| | - Sisto Perdonà
- Department of Urology, Istituto Nazionale Tumori, Fondazione G. Pascale, IRCCS, 80131, Naples, Italy
| | - Gerardo Botti
- Pathology Unit, Istituto Nazionale Tumori, Fondazione G. Pascale, IRCCS, 80131, Naples, Italy
| | - Gaetano Facchini
- Medical Oncology Unit, S.M. delle Grazie Hospital, Via Domitiana, 80078, Pozzuoli, NA, Italy
| | - Francesco Fiorentino
- Pathology Unit, S.M. delle Grazie Hospital, Via Domitiana, 80078, Pozzuoli, NA, Italy
| | - Giovanni Di Lauro
- Urology Unit, S.M. delle Grazie Hospital, Via Domitiana, 80078, Pozzuoli (NA), Italy
| | - Marco De Sio
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli, 80138, Naples, Italy
| | - Ferdinando De Vita
- Division of Medical Oncology, Department of Precision Medicine, School of Medicine, "Luigi Vanvitelli" University of Campania, Naples, Italy
| | - Giorgio Toni
- Laboratoire Central d'Anatomie pathologique, Hôpital universitaire de Nice, Université Côte d'Azur, 06000, Nice, France
| | - Rodolfo Borges Dos Reis
- Department of Surgery and Anatomy, Urology Division, Ribeirao Preto School Medicine, University of São Paulo, 14049 900, Ribeirao Preto, Brazil
| | - Luciano Neder
- Department of Pathology and Forensic Medicine, Ribeirão Preto Medical School, University of São Paulo, 14049 900, Ribeirão Preto, SP, Brazil.,Molecular Oncology Research Center, Barretos Cancer Hospital, 14784400, Barretos, SP, Brazil
| | - Renato Franco
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "L. Vanvitelli", Complesso di Santa Patrizia, Via Luciano Armanni, 5, 80138, Naples, Italy.
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Ahmed ME, Falasiri S, Hajiran A, Chahoud J, Spiess PE. The Immune Microenvironment in Penile Cancer and Rationale for Immunotherapy. J Clin Med 2020; 9:E3334. [PMID: 33080912 PMCID: PMC7603091 DOI: 10.3390/jcm9103334] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/07/2020] [Accepted: 10/12/2020] [Indexed: 02/07/2023] Open
Abstract
Penile cancer is an extremely rare malignancy that accounts for approximately 1% of cancer deaths in the United States every year. While primary penile cancer can be managed surgically, advanced and metastatic forms of the disease require more aggressive management plans with systemic chemotherapy and/or radiotherapy. Despite the meaningful response to systemic treatments, the 2-year progression-free survival and disease-specific survival have shown disappointing results. Therefore, there is a crucial need for alternative treatment options with more favorable outcomes and a lower toxicity profile. There are currently extensive studies of tumor molecular biology and clinical trials with targeted molecular therapies, such as PD-1, PD-L1, and CTLA-4. In this review, we will describe the penile cancer microenvironment, and summarize the rationale for immunotherapy in penile cancer patients.
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Affiliation(s)
| | - Shayan Falasiri
- Department of Urology, University of South Florida Morsani College of Medicine, Tampa, FL 33612, USA;
| | - Ali Hajiran
- Department of Genitourinary Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA; (A.H.); (J.C.); (P.E.S.)
| | - Jad Chahoud
- Department of Genitourinary Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA; (A.H.); (J.C.); (P.E.S.)
| | - Philippe E. Spiess
- Department of Genitourinary Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA; (A.H.); (J.C.); (P.E.S.)
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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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Hu J, Li H, He T, Deng H, Gong G, Cui Y, Liu P, Ren W, Li C, Chen J, Zu X. A nomogram incorporating PD-L1, NLR, and clinicopathologic features to predict inguinal lymph node metastasis in penile squamous cell carcinoma. Urol Oncol 2020; 38:641.e19-641.e29. [PMID: 32389428 DOI: 10.1016/j.urolonc.2020.04.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 03/30/2020] [Accepted: 04/04/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Accurate preoperative prediction of inguinal lymph node metastasis (LNM) aids in clinical decision making, especially for patients with penile cancer with clinically negative lymph nodes. We aim to develop a nomogram to predict the preoperative risk of LNM by incorporating clinicopathologic features and tumor biomarkers. METHODS Eighty-four patients with penile cancer with clinically negative lymph nodes were enrolled. The programmed death ligand 1 (PD-L1) expression profile was detected by immunohistochemistry. The neutrophil-to-lymphocyte ratio (NLR) was calculated based on parameters of a routine blood examination. Multivariate logistic regression analysis was utilized to construct predictive nomograms for LNM based on data of 64 patients. The nomogram performance was assessed for calibration, discrimination, and clinical use. RESULTS Tumor grade, lymphovascular invasion, PD-L1, and NLR were independent predictors of LNM. Then, 4 prediction models were constructed. Clinical model included tumor grade and lymphovascular invasion. NLR model was built by adding the NLR to clinical model. PD-L1 model was built by adding the PD-L1 to clinical model. Finally, a combined model was built by adding both PD-L1 and NLR to clinical model. Combined model showed the best performance compared with other models. It showed good discrimination with a C-index of 0.89, and good calibration. In addition, decision curve analysis suggested that model 4 was clinically useful. CONCLUSIONS We developed a nomogram that incorporated tumor grade, lymphovascular invasion, PD-L1, and NLR that could be conveniently used to predict the preoperative individualized risk of inguinal LNM in patients with penile cancer.
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Affiliation(s)
- Jiao Hu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Huihuang Li
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Tongchen He
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Hao Deng
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Guanghui Gong
- Department of Pathology, Xiangya Hospital, Central South University, Changsha, China
| | - Yu Cui
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Peihua Liu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Wenbiao Ren
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Chao Li
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Jinbo Chen
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China.
| | - Xiongbing Zu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China.
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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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Ramsauer AS, Wachoski-Dark GL, Fraefel C, Tobler K, Brandt S, Knight CG, Favrot C, Grest P. Paving the way for more precise diagnosis of EcPV2-associated equine penile lesions. BMC Vet Res 2019; 15:356. [PMID: 31640696 PMCID: PMC6805557 DOI: 10.1186/s12917-019-2097-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 09/16/2019] [Indexed: 01/15/2023] Open
Abstract
Background There is growing evidence that equine papillomavirus type 2 (EcPV2) infection is causally associated with the development of equine genital squamous cell carcinomas (SCCs). Early stages of disease present clinically as plaques or wart-like lesions which can gradually progress to tumoural lesions. Histologically these lesions are inconsistently described as benign hyperplasia, papilloma, penile intraepithelial neoplasia (PIN), carcinoma in situ (CIS) or SCC. Guidelines for histological classification of early SCC precursor lesions are not precisely defined, leading to potential misdiagnosis. The aim of this study was to identify histologic criteria and diagnostic markers allowing for a more accurate diagnosis of EcPV2-associated equine penile lesions. Results A total of 61 archived equine penile lesions were histologically re-assessed and classified as benign hyperplasia, papilloma, CIS or SCC. From these, 19 representative lesions and adjacent normal skin were comparatively analysed for the presence of EcPV2 DNA and transcripts using PCR and RNA in situ hybridisation (RISH). All lesional samples were positive by EcPV2 PCR and RISH, while adjacent normal skin was negative. RISH analysis yielded signal distribution patterns that allowed distinction of early (hyperplasia, papilloma) from late stage lesions (CIS, SCC). Subsequently, the 19 lesions were further assessed for expression of p53, Ki67, MCM7 and MMP1 by immunohistochemistry (IHC). All four proteins were expressed in both normal and lesional tissue. However, p53 expression was up-regulated in basal keratinocyte layers of papillomas, CIS and SCCs, as well as in upper keratinocyte layers of CIS and SCCs. MCM7 expression was only up-regulated in upper proliferating keratinocyte layers of papillomas, CIS and SCCs. Conclusion This study proposes combining a refined histological protocol for analysis of equine penile lesions with PCR- and/or RISH based EcPV2-screening and p53/MCM7 IHC to more accurately determine the type of lesion. This may help to guide the choice of optimum treatment strategy, especially at early stages of disease.
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Affiliation(s)
- Anna Sophie Ramsauer
- Institute of Virology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland. .,Dermatology Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
| | - Garrett Louis Wachoski-Dark
- Department of Veterinary Clinical and Diagnostic Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary, Canada
| | - Cornel Fraefel
- Institute of Virology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Kurt Tobler
- Institute of Virology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Sabine Brandt
- Research Group Oncology, Equine Clinic, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Cameron Greig Knight
- Department of Veterinary Clinical and Diagnostic Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary, Canada
| | - Claude Favrot
- Dermatology Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Paula Grest
- Institute of Veterinary Pathology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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Hu J, Cui Y, Liu P, Zhou X, Ren W, Chen J, Zu X. Predictors of inguinal lymph node metastasis in penile cancer patients: a meta-analysis of retrospective studies. Cancer Manag Res 2019; 11:6425-6441. [PMID: 31372046 PMCID: PMC6628149 DOI: 10.2147/cmar.s206579] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Accepted: 05/25/2019] [Indexed: 12/11/2022] Open
Abstract
Purpose Inguinal lymph node metastasis (LNM) is one of the most significant prognostic factors for patients with penile cancer. This study aimed to identify potential predictors of inguinal LNM. Patients and methods A comprehensive search of the PubMed, Embase, and Cochrane Library databases for studies that reported predictors of inguinal LNM in penile cancer was performed. Finally, we selected 42 eligible studies with 4,802 patients. Accumulative analyses of odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were performed. All analyses were performed by using Review Manager software version 5.3. Results Among the 4,802 patients, 1,706 (36%) were diagnosed with inguinal LNM. Predictors of LNM included two categories: tumor-associated biomarkers and invasive clinicopathologic characteristics. Biomarker-specific predictors: the program death ligand 1 (PD-L1) overexpression (OR=2.55, p=0.002), higher neutrophil-to-lymphocyte ratio (NLR) (OR=4.22, p=0.010), higher C-reactive protein (CRP) (OR=4.78, p<0.001), squamous cell carcinoma antigen (SCC-Ag) overexpression (OR=8.52, p<0.001), P53 protein overexpression (OR=3.57, p<0.001). Clinicopathological predictors: positive clinical lymph node (cN+) (OR=5.86, p<0.001), high-risk histopathological subtype (OR=14.63, p<0.001) and intermediate-risk subtype (OR=3.37, p<0.001), vertical growth pattern (OR=1.97, p=0.020), higher stage (AJCC: OR=3.66, p<0.001; UICC: OR=2.43, p<0.001), higher tumor grade (OR=3.37, p<0.001), tumor size (>3 cm) (OR=2.00, p=0.002), LVI (OR=3.37, p<0.001), invasion depth (>5 mm) (OR=2.58, p=0.002), nerve invasion (OR=2.84, p<0.001), corpora cavernosum invasion (OR=2.22, p<0.001), corpus spongiosum invasion (OR=1.73, p=0.002) and urethra invasion (OR=1.81, p=0.030). Conclusion Current meta-analysis conclusively identified valuable predictors of inguinal LNM for patients with penile cancer. However, high-quality studies are warranted to further validate our conclusions. The intrinsic link between these predictors needs to be further investigated to create an accurate mathematical prediction model for LNM.
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Affiliation(s)
- Jiao Hu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Yu Cui
- Department of Urology, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Peihua Liu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Xu Zhou
- Reproductive Medicine Center, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Wenbiao Ren
- Department of Urology, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Jinbo Chen
- Department of Urology, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Xiongbing Zu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, People's Republic of China
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Prapiska FF, Warli SM. P53 and Survival Rate in Penile Cancer. Open Access Maced J Med Sci 2019; 7:1170-1173. [PMID: 31049102 PMCID: PMC6490473 DOI: 10.3889/oamjms.2019.219] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/17/2019] [Accepted: 03/18/2019] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Penile cancer accounts for 0.4-0.6% of all malignancy in men in Europe and the United States of America. It also accounts for 10% of all malignancy in men in some Asian, South American, and African countries. P53 protein has the function to regulate apoptosis in the cell cycle. Therefore, the presence of p53 in cells may indicate higher proliferative activity of the cells as a feedback mechanism, indicating disease progression. AIM This study aims to identify the association between p53 expression and survival rate in penile cancer patients. METHODS This study was a retrospective observational analytic study. This study was conducted in Pathology Anatomy Laboratory Faculty of the Medicine University of Sumatera Utara/Haji Adam Malik Hospital/University of Sumatera Utara Hospital to assess p53 expression. This study was conducted from January 2018 to December 2018. RESULTS The total subjects in this study were 33 with the mean age of 50.79 ± 10.62. Based on clinical stage, patients in this study are divided into 11 patients (33.3%) in stage T II and 22 patients (66.7%) in stage T III/T IV. P53 expression was positive in 13 patients (35.3%). There were 19 patients (57.6) alive and 14 patients (42.4%) deceased. Statistical analysis using chi-square showed that there was an association between p53 expression and mortality (p = 0.011). In the Kaplan-Meier Curve for 3-year overall survival based on p53 expression, the survival rate in 36 months in the p53 positive group is 18%, while in p53 negative group, the survival rate was 60%. The survival rate based on p53 status was significantly different (p = 0.025). CONCLUSION There is a significant association between p53 expression and mortality in penile cancer patients. In conclusion, p53 expression in penile cancer cells examined by immunohistochemistry may show prognostic values in the disease progression.
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Affiliation(s)
| | - Syah Mirsya Warli
- Department of Urology, University of Sumatera Utara Hospital, Medan, Indonesia
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Azizi M, Tang DH, Verduzco D, Peyton CC, Chipollini J, Yuan Z, Schaible BJ, Zhou JM, Johnstone PA, Giuliano A, Dhillon J, Spiess PE. Impact of PI3K-AKT-mTOR Signaling Pathway Up-regulation on Prognosis of Penile Squamous-Cell Carcinoma: Results From a Tissue Microarray Study and Review of the Literature. Clin Genitourin Cancer 2019; 17:e80-e91. [DOI: 10.1016/j.clgc.2018.09.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 09/18/2018] [Accepted: 09/18/2018] [Indexed: 12/26/2022]
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Olesen TB, Sand FL, Rasmussen CL, Albieri V, Toft BG, Norrild B, Munk C, Kjær SK. Prevalence of human papillomavirus DNA and p16 INK4a in penile cancer and penile intraepithelial neoplasia: a systematic review and meta-analysis. Lancet Oncol 2018; 20:145-158. [PMID: 30573285 DOI: 10.1016/s1470-2045(18)30682-x] [Citation(s) in RCA: 135] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 08/25/2018] [Accepted: 09/04/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND Although previous meta-analyses have examined human papillomavirus (HPV) DNA prevalence in penile cancer, none, to our knowledge, have assessed pooled HPV DNA prevalence in penile intraepithelial neoplasia or p16INK4a percent positivity in penile cancer and penile intraepithelial neoplasia. Therefore, we aimed to examine the prevalence of HPV DNA and p16INK4a positivity in penile cancer and penile intraepithelial neoplasia worldwide. METHODS In this systematic review and meta-analysis, we searched PubMed, Embase, and the Cochrane Library until July 24, 2017, for English-language articles published from Jan 1, 1986, onwards reporting the prevalence of HPV DNA and p16INK4a positivity, either alone or in combination, in at least five cases of penile cancer or penile intraepithelial neoplasia. Only studies that used PCR or hybrid capture for the detection of HPV DNA and immunohistochemical staining or methylation for the detection of p16INK4a were included. Data were extracted and subsequently crosschecked, and inconsistencies were discussed to reach consensus. Using random-effects models, we estimated the pooled prevalence and 95% CI of HPV DNA and p16INK4a positivity in penile cancer and penile intraepithelial neoplasia, stratifying by histological subtype and HPV DNA or p16INK4a detection method. Type-specific prevalence of HPV6, HPV11, HPV16, HPV18, HPV31, HPV33, and HPV45 in penile cancer was estimated. FINDINGS Our searches identified 1836 non-duplicate records, of which 73 relevant papers (71 studies) were found to be eligible. The pooled HPV DNA prevalence in penile cancer (52 studies; n=4199) was 50·8% (95% CI 44·8-56·7; I2=92·6%, pheterogeneity<0·0001). A high pooled HPV DNA prevalence was seen in basaloid squamous cell carcinomas (84·0%, 95% CI 71·0-93·6; I2=48·0%, pheterogeneity=0·0197) and in warty-basaloid carcinoma (75·7%, 70·1-81·0; I2=0%, pheterogeneity=0·52). The predominant oncogenic HPV type in penile cancer was HPV16 (68·3%, 95% CI 58·9-77·1), followed by HPV6 (8·1%, 4·0-13·7) and HPV18 (6·9%, 2·9-12·4). The pooled HPV DNA prevalence in penile intraepithelial neoplasia (19 studies; n=445) was 79·8% (95% CI 69·3-88·6; I2=83·2%, pheterogeneity<0·0001). The pooled p16INK4a percent positivity in penile cancer (24 studies; n=2295) was 41·6% (95% CI 36·2-47·0; I2=80·6%, pheterogeneity<0·0001), with a high pooled p16INK4a percent positivity in HPV-related squamous cell carcinoma (85·8%, 95% CI 72·1-95·4; I2=56·4%, pheterogeneity=0·0011) as compared with non-HPV-related squamous cell carcinoma (17·1%, 7·9-29·1; I2=78·3%, pheterogeneity<0·0001). Moreover, among HPV-positive cases of penile cancer, the p16INK4a percent positivity was 79·6% (95% CI 65·7-90·7; I2=89·9%, pheterogeneity<0·0001), compared with 18·5% (9·6-29·6; I2=89·3%, pheterogeneity<0·0001) in HPV-negative penile cancers. The pooled p16INK4a percent positivity in penile intraepithelial neoplasia (six studies; n=167) was 49·5% (95% CI 18·6-80·7). INTERPRETATION A large proportion of penile cancers and penile intraepithelial neoplasias are associated with infection with HPV DNA (predominantly HPV16), emphasising the possible benefits of HPV vaccination in men and boys. FUNDING None.
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Affiliation(s)
- Tina Bech Olesen
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Centre, Copenhagen, Denmark
| | - Freja Lærke Sand
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Centre, Copenhagen, Denmark
| | | | - Vanna Albieri
- Unit of Statistics and Pharmacoepidemiology, Danish Cancer Society Research Centre, 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, Copenhagen, Denmark
| | - Susanne Krüger Kjær
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Centre, Copenhagen, Denmark; Department of Gynaecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
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Malignant transformation of canine oral papillomavirus (CPV1)-associated papillomas in dogs: An emerging concern? PAPILLOMAVIRUS RESEARCH 2018; 6:83-89. [PMID: 30414951 PMCID: PMC6260289 DOI: 10.1016/j.pvr.2018.10.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 10/21/2018] [Accepted: 10/28/2018] [Indexed: 01/24/2023]
Abstract
Canine oral papillomavirus (CPV1, also known as COPV), the most common cause of non-neoplastic papillomas, has not been shown to cause squamous cell carcinomas (SCC). Furthermore, malignant transformation of benign papillomas to SCC has only been reported in a single group of dogs with severe combined immunodeficiency infected with CPV2. Here, we report a series of 7 dogs with benign CPV1-associated papillomas with histologic evidence of CPV1 causing malignant transformation to carcinoma in situ and ultimately SCC. Expression of p53 and p16 proteins in CPV1-infected cells within the benign papillomas and lesions that progressed into SCC also supported an association between papillomavirus and malignant transformation. Moreover, our retrospective analysis indicated that while there have been increased numbers of viral papillomas with malignant transformation, the number of annually diagnosed canine viral papillomas has remained constant over the past decade in our laboratory. We speculate that either an altered host immunity from increased usage of immunosuppressive drugs or changing environmental factors, e.g. increase exposure to UV radiation, may cause an increased oncogenic potential of this “low-risk” virus. This study aims to raise awareness of the malignant potential of CPV1 and to encourage further investigations into the cause of this suspected change in its oncogenic potential.
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REPLY. Urology 2018; 120:94-95. [DOI: 10.1016/j.urology.2018.03.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 03/08/2018] [Accepted: 03/22/2018] [Indexed: 11/22/2022]
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Prognostic Significance of P16 INK4a Expression in Penile Squamous Cell Carcinoma: A Meta-Analysis with Trial Sequential Analysis. BIOMED RESEARCH INTERNATIONAL 2018; 2018:8345893. [PMID: 30105253 PMCID: PMC6076906 DOI: 10.1155/2018/8345893] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 06/02/2018] [Accepted: 06/05/2018] [Indexed: 01/01/2023]
Abstract
Background Recently, P16INK4a expression has been shown to be correlated with cancer-specific survival (CSS) in penile squamous cell carcinoma (SCC). Therefore, we performed this meta-analysis to clarify the prognostic value of P16INK4a for penile SCC. Methods A systematic search was performed in PubMed, Embase, and Web of Science to identify all relevant articles up to May 25, 2017. Hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) of included studies were pooled to estimate the prognostic value. Trial sequential analysis (TSA) was performed to assess the quantity and strength of survival evidence. Results Five retrospective studies consisting of 323 cases were finally included. We found that P16INK4a positive expression was significantly associated with a better CSS of penile SCC (HR=0.45, 95%CI: 0.30-0.67, P<0.001). No heterogeneity or publication bias was noted among the included studies. Furthermore, TSA demonstrated that the findings were based on sufficient evidence. Conclusions P16INK4a positive expression is independently associated with improved CSS for patients with penile SCC.
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Sand FL, Rasmussen CL, Frederiksen MH, Andersen KK, Kjaer SK. Prognostic Significance of HPV and p16 Status in Men Diagnosed with Penile Cancer: A Systematic Review and Meta-analysis. Cancer Epidemiol Biomarkers Prev 2018; 27:1123-1132. [DOI: 10.1158/1055-9965.epi-18-0322] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 06/07/2018] [Accepted: 07/02/2018] [Indexed: 11/16/2022] Open
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31
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Zhou QH, Deng CZ, Li ZS, Chen JP, Yao K, Huang KB, Liu TY, Liu ZW, Qin ZK, Zhou FJ, Huang W, Han H, Liu RY. Molecular characterization and integrative genomic analysis of a panel of newly established penile cancer cell lines. Cell Death Dis 2018; 9:684. [PMID: 29880898 PMCID: PMC5992159 DOI: 10.1038/s41419-018-0736-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 05/06/2018] [Accepted: 05/08/2018] [Indexed: 12/22/2022]
Abstract
Cell line models are essential tools to study the molecular mechanisms underlying tumor initiation and progression. There are limited treatment options for penile squamous cell carcinoma (PSCC), accounting for 1–2% of male tumors in developing countries, and limited progress in preclinical research in PSCC due to lacking available models with identified genomic characteristics. Here, biological and molecular characteristics and whole-genomic alterations were analyzed in a panel of PSCC cell lines newly established in our laboratory. These cell lines were all human papillomavirus (HPV)-negative, epithelial-like, immortalized, and tumorigenic in nude mice, whereas they displayed different proliferation, migration and invasion capacities in vitro, and tumorigenic ability in nude mice. They were all cisplatin sensitive, anti-EGFR therapy resistant, and androgen irresponsive. Whole-genomic sequecing analysis revealed that transition mutations (C:G>T:A and T:A>C:G) were the most common substitution types in these cell lines, whereas ERCC5, TP53, PTH1, CLTCL1, NOTCH2, MAP2K3, CDK11A/B, USP6, ADCH5, BCLAF1, CDKN2A, FANCD2, HRAS, and NOTCH1 were the most frequently altered genes. Amplifications of MYC, PLAG1, NCOA2, RUNX1T1, COX6C, and EGFR and losses of FBXW7, TET2, XPC, and FANCE were frequently observed in cell lines. The exomic variations between cell lines and their corresponding cancer tissues were highly consistent. Genetic variations were mainly involved in the MAPK, Jak-STAT, TGF-beta, Notch, and apoptosis signaling pathways. Conclusively, these panel of PSCC cell lines established in our laboratory harbor some common or specific biological characteristics and genomic variations, and they may serve as optimal models to investigate the molecular mechanisms underlying the progression, metastasis, relapses, and treatment resistance of PSCC and to develop effective treatment strategy.
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Affiliation(s)
- Qiang-Hua Zhou
- Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, 510060, Guangzhou, China.,Department of Urology, Sun Yat-Sen University Cancer Center, 510060, Guangzhou, China
| | - Chuang-Zhong Deng
- Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, 510060, Guangzhou, China
| | - Zai-Shang Li
- Department of Urology, Shenzhen People's Hospital, Jinan University, 518020, Shenzhen, China
| | - Jie-Ping Chen
- Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, 510060, Guangzhou, China
| | - Kai Yao
- Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, 510060, Guangzhou, China.,Department of Urology, Sun Yat-Sen University Cancer Center, 510060, Guangzhou, China
| | - Kang-Bo Huang
- Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, 510060, Guangzhou, China.,Department of Urology, Sun Yat-Sen University Cancer Center, 510060, Guangzhou, China
| | - Ting-Yu Liu
- Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, 510060, Guangzhou, China.,Department of Urology, Sun Yat-Sen University Cancer Center, 510060, Guangzhou, China
| | - Zhuo-Wei Liu
- Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, 510060, Guangzhou, China.,Department of Urology, Sun Yat-Sen University Cancer Center, 510060, Guangzhou, China
| | - Zi-Ke Qin
- Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, 510060, Guangzhou, China.,Department of Urology, Sun Yat-Sen University Cancer Center, 510060, Guangzhou, China
| | - Fang-Jian Zhou
- Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, 510060, Guangzhou, China.,Department of Urology, Sun Yat-Sen University Cancer Center, 510060, Guangzhou, China
| | - Wenlin Huang
- Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, 510060, Guangzhou, China.,Guangdong Provincial Key Laboratory of Tumor Targeted Drugs and Guangzhou Enterprise Key Laboratory of Gene Medicine, Guangzhou Doublle Bioproducts Co. Ltd., 510663, Guangzhou, China
| | - Hui Han
- Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, 510060, Guangzhou, China. .,Department of Urology, Sun Yat-Sen University Cancer Center, 510060, Guangzhou, China.
| | - Ran-Yi Liu
- Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, 510060, Guangzhou, China.
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Yuan Z, Naghavi AO, Tang D, Kim Y, Ahmed KA, Dhillon J, Giuliano AR, Spiess PE, Johnstone PA. The relationship between HPV status and chemoradiotherapy in the locoregional control of penile cancer. World J Urol 2018; 36:1431-1440. [PMID: 29589134 DOI: 10.1007/s00345-018-2280-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Accepted: 03/24/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Penile cancer (PeCa) is a rare, aggressive malignancy often associated with the human papillomavirus (HPV). The practice of a personalized risk-adapted approach is not yet established. This study is to assess the relationship between HPV tumor status and chemoradiotherapy (CRT) in PeCa locoregional control (LRC). METHODS We retrospectively identified patients with HPV status who were diagnosed with squamous cell carcinoma of the penis and treated with surgical resection between 1999 and 2016. The relationship between tumor/treatment characteristics and LRC were analyzed with univariate and multivariate Cox proportional hazard regression analysis (UVA and MVA, respectively). Time-to-event outcomes were estimated with Kaplan-Meier curves and compared via log-rank tests. RESULTS Fifty-one patients were identified. The median follow-up was 36.6 months. Patients were primarily HPV-negative (HPV-) (n = 28, 55%), and pathologic node positive (pN+) (55%). The 2 year LRC rate was 54%. pN+ patients had a significantly lower 2 year LRC (37 vs. 81%, p = 0.002). In the subgroup analysis of pN+ patients (n = 28), there was a LRC benefit associated with the addition of CRT (HR 0.19; 95% CI 0.05-0.70, p = 0.012) and HPV-positive (HPV+) disease (HR 0.18; 95% CI 0.039-0.80, p = 0.024) using MVA. HPV+ patients treated with CRT had improved 2 year LRC compared to HPV- patients (83 vs. 38%, p = 0.038). CONCLUSIONS Adjuvant CRT and HPV+ disease independently predicted for improved LRC in pN+ PeCa. In HPV+ PeCa, the LRC benefit was primarily observed in patients treated with adjuvant CRT. Prospective investigation of HPV+ and CRT is required to further delineate their roles in optimizing PeCa treatment.
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Affiliation(s)
- Zhigang Yuan
- Department of Radiation Oncology, H Lee Moffitt Cancer Center and Research Institute, 12902 USF Magnolia Dr, Tampa, FL, 33612, USA
| | - Arash O Naghavi
- Department of Radiation Oncology, H Lee Moffitt Cancer Center and Research Institute, 12902 USF Magnolia Dr, Tampa, FL, 33612, USA
| | - Dominic Tang
- Department of Genitourinary Oncology, H Lee Moffitt Cancer Center and Research Institute, 12902 USF Magnolia Dr, Tampa, FL, 33612, USA
| | - Youngchul Kim
- Department of Biostatistics and Bioinformatics, H Lee Moffitt Cancer Center and Research Institute, 12902 USF Magnolia Dr, Tampa, FL, 33612, USA
| | - Kamran A Ahmed
- Department of Radiation Oncology, H Lee Moffitt Cancer Center and Research Institute, 12902 USF Magnolia Dr, Tampa, FL, 33612, USA
| | - Jasreman Dhillon
- Department of Anatomic Pathology, H Lee Moffitt Cancer Center and Research Institute, 12902 USF Magnolia Dr, Tampa, FL, 33612, USA
| | - Anna R Giuliano
- Department of Cancer Epidemiology, H Lee Moffitt Cancer Center and Research Institute, 12902 USF Magnolia Dr, Tampa, FL, 33612, USA
| | - Philippe E Spiess
- Department of Genitourinary Oncology, H Lee Moffitt Cancer Center and Research Institute, 12902 USF Magnolia Dr, Tampa, FL, 33612, USA
| | - Peter A Johnstone
- Department of Radiation Oncology, H Lee Moffitt Cancer Center and Research Institute, 12902 USF Magnolia Dr, Tampa, FL, 33612, USA.
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Zargar-Shoshtari K, Sharma P, Spiess PE. Insight into novel biomarkers in penile cancer: Redefining the present and future treatment paradigm? Urol Oncol 2017; 36:433-439. [PMID: 29103967 DOI: 10.1016/j.urolonc.2017.10.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 07/20/2017] [Accepted: 10/10/2017] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Biomarkers are increasingly used in the diagnosis and management of various malignancies. Selected biomarkers may also play a role in management of certain cases of penile carcinoma. In this article, we provide an overview of the clinical role of such markers in the management of penile cancer. METHOD This is a nonsystematic review of relevant literature assessing biomarkers in penile carcinoma. RESULTS Evidence of infections with human papillomavirus and its surrogate markers may have important prognostic value in patients with localized or metastatic penile cancer. Squamous cell carcinoma antigen, p53, C-reactive protein, Ki-67, proliferating cell nuclear antigen, cyclin D1, as well as other markers have been studied with various degree of evidence in support of clinical utility in penile cancer. CONCLUSIONS No single marker may have all the answers, and future research should focus on genomic analysis of individual penile tumors, attempting to identify specific targets for treatment.
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Affiliation(s)
| | - Pranav Sharma
- Department of Urology, Texas Tech Health Sciences Center, Lubbock, TX
| | - Philippe E Spiess
- Departments of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL.
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Kuasne H, Barros-Filho MC, Busso-Lopes A, Marchi FA, Pinheiro M, Muñoz JJM, Scapulatempo-Neto C, Faria EF, Guimarães GC, Lopes A, Trindade-Filho JCS, Domingues MAC, Drigo SA, Rogatto SR. Integrative miRNA and mRNA analysis in penile carcinomas reveals markers and pathways with potential clinical impact. Oncotarget 2017; 8:15294-15306. [PMID: 28122331 PMCID: PMC5362487 DOI: 10.18632/oncotarget.14783] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Accepted: 01/10/2017] [Indexed: 12/14/2022] Open
Abstract
Penile carcinoma (PeCa) is an important public health issue in poor and developing countries, and has only recently been explored in terms of genetic and epigenetic studies. Integrative data analysis is a powerful method for the identification of molecular drivers involved in cancer development and progression. miRNA and mRNA expression profiles followed by integrative analysis were investigated in 23 PeCa and 12 non-neoplastic penile tissues (NPT). Expression levels of eight miRNAs and 10 mRNAs were evaluated in the same set of samples used for microarray and in a validation set of cases (PeCa = 36; NPT = 27). Eighty-one miRNAs and 2,697 mRNAs were identified as differentially expressed in PeCa. Integrative data analysis revealed 255 mRNAs potentially regulated by 68 miRNAs. Using RT-qPCR, eight miRNAs and nine transcripts were confirmed as altered in PeCa. We identified that MMP1, MMP12 and PPARG and hsa-miR-31-5p, hsa-miR-224-5p, and hsa-miR-223-3p were able to distinguish tumors from NPT with high sensitivity and specificity. Higher MMP1 expression was detected as a better predictor of lymph node metastasis than the clinical-pathological data. In addition, PPARG and EGFR were highlighted as potential pathways for targeted therapy in PeCa. The analysis based on HPV positivity (7 of 23 cases) revealed five miRNA and 13 mRNA differentially expressed. Although in a limited number of cases, HPV positive PeCa presented less aggressive phenotype in comparison with negative cases. Overall, an integrative analysis using mRNA and miRNA profiles revealed markers related with tumor development and progression. Furthermore, MMP1 expression level was a predictive marker for lymph node metastasis in patients with PeCa.
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Affiliation(s)
- Hellen Kuasne
- CIPE-A. C. Camargo Cancer Center, São Paulo, Brazil.,Department of Urology, Faculty of Medicine, São Paulo State University-UNESP, Botucatu, São Paulo, Brazil
| | | | | | | | | | | | | | - Eliney F Faria
- Department of Urology, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | | | - Ademar Lopes
- Department of Urology, A. C. Camargo Cancer Center, São Paulo, Brazil
| | - José C S Trindade-Filho
- Department of Urology, Faculty of Medicine, São Paulo State University-UNESP, Botucatu, São Paulo, Brazil
| | | | - Sandra A Drigo
- Department of Urology, Faculty of Medicine, São Paulo State University-UNESP, Botucatu, São Paulo, Brazil
| | - Silvia R Rogatto
- CIPE-A. C. Camargo Cancer Center, São Paulo, Brazil.,Department of Urology, Faculty of Medicine, São Paulo State University-UNESP, Botucatu, São Paulo, Brazil.,Department of Clinical Genetics, Vejle Sygehus, Vejle, Denmark.,Institute of Regional Health, University of Southern Denmark, Denmark
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35
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Afonso LA, Carestiato FN, Ornellas AA, Ornellas P, Rocha WM, Cordeiro TI, Lisboa DC, Alves GB, Cavalcanti SMB. Human papillomavirus, Epstein-Barr virus, and methylation status of p16ink4ain penile cancer. J Med Virol 2017; 89:1837-1843. [DOI: 10.1002/jmv.24833] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 03/19/2017] [Accepted: 03/20/2017] [Indexed: 12/22/2022]
Affiliation(s)
- Larissa Alves Afonso
- From the Department of Microbiology and Parasitology Biomedical Institute; Federal Fluminense University; Niterói Rio de Janeiro Brazil
| | - Fernanda Nahoum Carestiato
- From the Department of Microbiology and Parasitology Biomedical Institute; Federal Fluminense University; Niterói Rio de Janeiro Brazil
| | - Antonio Augusto Ornellas
- Departments of Urology; Brazilian National Cancer Institute and Hospital Mário Kröeff; Rio de Janeiro Brazil
| | - Paulo Ornellas
- Circulating Biomarkers Laboratory; Department of Pathology; Rio de Janeiro Brazil
- Programa de Pós-Graduação em Ciências Médicas (PGCM); Rio de Janeiro State University; Rio de Janeiro Brazil
| | - Willker Menezes Rocha
- From the Department of Microbiology and Parasitology Biomedical Institute; Federal Fluminense University; Niterói Rio de Janeiro Brazil
| | - Thaissa Isaias Cordeiro
- From the Department of Microbiology and Parasitology Biomedical Institute; Federal Fluminense University; Niterói Rio de Janeiro Brazil
| | - Daniela Ceperuelo Lisboa
- From the Department of Microbiology and Parasitology Biomedical Institute; Federal Fluminense University; Niterói Rio de Janeiro Brazil
| | - Gilda Brown Alves
- Circulating Biomarkers Laboratory; Department of Pathology; Rio de Janeiro Brazil
- Research Coordination; Brazilian National Cancer Institute; Rio de Janeiro Brazil
| | - Silvia Maria Baeta Cavalcanti
- From the Department of Microbiology and Parasitology Biomedical Institute; Federal Fluminense University; Niterói Rio de Janeiro Brazil
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