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Sanchez DF, Oliveira P. Pathology of Squamous Cell Carcinoma of the Penis: Back to Square One. Urol Clin North Am 2024; 51:313-325. [PMID: 38925734 DOI: 10.1016/j.ucl.2024.03.003] [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] [Indexed: 06/28/2024]
Abstract
The landscape of squamous cell carcinoma of the penis (SCC-P) has undergone a significant transformation since the new World Health Organization classification of genitourinary cancers and recent European Association of Urology/American Association of Clinical Oncology guidelines. These changes emphasize the necessity to categorize SCC-P into 2 groups based on its association with human papillomavirus (HPV) infection. This shift has major implications, considering that prior knowledge was derived from a mix of both groups. Given the distinct prognosis, treatment options, and staging systems observed for HPV-associated tumors in other body areas, the question now arises: will similar patterns emerge for SCC-P?
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Affiliation(s)
- Diego F Sanchez
- Translational Oncogenomics Group, Manchester Cancer Research Centre & CRUK-MI, Wilmslow Road, Manchester M20 4GJ, UK.
| | - Pedro Oliveira
- Department of Pathology, Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK
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2
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Sanchez DF, Fernández-Nestosa MJ, Alemany L, Cañete-Portillo S, Lloveras B, Clavero O, Rodríguez I, Quint W, Muñoz N, de Sanjosé S, Bosch FX, Cubilla AL. Detection of variable genotypes in common human papillomavirus-associated invasive penile squamous cell carcinomas: a study of 177 human papillomavirus-positive cases. Hum Pathol 2023; 139:65-72. [PMID: 37429448 DOI: 10.1016/j.humpath.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 06/29/2023] [Accepted: 07/05/2023] [Indexed: 07/12/2023]
Abstract
Human papillomavirus (HPV) is detected in 30-50% of invasive penile carcinomas, and it is frequently associated with basaloid and warty morphological features. Based on this heterogeneity and different clinical behaviors, we hypothesized a variation in their HPV genotypic composition. To test this, we evaluated 177 HPV-positive cases: basaloid (114), warty-basaloid (28), and warty (condylomatous) (35) invasive carcinomas. HPV DNA detection and genotyping was performed using the SPF-10/DEIA/LiPA25 system. Nineteen HPV genotypes were detected. High-risk HPVs predominated (96%), and low-risk HPVs were rarely present. Most common genotype was HPV16 followed by HPVs 33 and 35. According to the genotypes identified, 93% of the cases would be covered with current vaccination programs. There was a significant variation in the distribution of HPV16 and non-HPV16 genotypes according to histological subtype. HPV16 was significantly frequent in basaloid (87%) and was less frequent in warty carcinomas (61%). This molecular difference, along with their distinctive macro-microscopic and prognostic features, makes basaloid and warty carcinomas unique. The gradual decreasing frequency of HPV16 demonstrated in basaloid, warty-basaloid, and warty carcinomas suggest that the basaloid cell, present in those types in decreasing proportions, may be responsible for the differences.
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Affiliation(s)
- Diego F Sanchez
- Instituto de Patología e Investigación, Asunción 1228, Paraguay; Translational Oncogenomics Group, Cancer Research UK Manchester Institute, University of Manchester, Manchester Cancer Research Centre, Manchester M20 4GJ, UK
| | | | - Laia Alemany
- Institut Català D'Oncologia, Barcelona 08908, Spain
| | | | | | - Omar Clavero
- Institut Català D'Oncologia, Barcelona 08908, Spain
| | - Ingrid Rodríguez
- Instituto de Patología e Investigación, Asunción 1228, Paraguay; Universidad Nacional de Asunción, San Lorenzo 2111, Paraguay
| | - Wim Quint
- DDL Diagnostic Laboratory, Rijswijk 2288, Netherlands
| | - Nubia Muñoz
- National Cancer Institute of Colombia, Bogotá 111511-110411001, Colombia
| | - Silvia de Sanjosé
- Barcelona Institute for Global Health (ISGlobal), Barcelona 08036, Spain
| | | | - Antonio L Cubilla
- Instituto de Patología e Investigación, Asunción 1228, Paraguay; Universidad Nacional de Asunción, San Lorenzo 2111, Paraguay.
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da Silva LL, Teles AM, Santos JMO, Souza de Andrade M, Medeiros R, Faustino-Rocha AI, Oliveira PA, dos Santos APA, Ferreira Lopes F, Braz G, Brito HO, da Costa RMG. Malignancy Associated with Low-Risk HPV6 and HPV11: A Systematic Review and Implications for Cancer Prevention. Cancers (Basel) 2023; 15:4068. [PMID: 37627099 PMCID: PMC10452364 DOI: 10.3390/cancers15164068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/28/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
High-risk human papillomavirus (HPV) is etiologically related to cervical cancer, other anogenital cancers and oropharyngeal carcinomas. Low-risk HPV, especially HPV6 and HPV11, cause genital warts and laryngeal papillomas. However, the accumulating data suggests that HPV6 and HPV11 may cause malignant lesions at non-cervical anatomic sites. This review aims to estimate the proportions of single and dual HPV6/11 infections in multiple cancers reported in the last 10 years in the Cochrane, Embasa and PubMed databases. Secondly, the genomes of HPV6/11 were compared with the most common high-risk genotype, HPV16, to determine the similarities and differences. A total of 11 articles were selected, including between one and 334 HPV+ cancer patients. The frequencies of single or dual HPV6/11 infections ranged between 0-5.5% for penile and 0-87.5% for laryngeal cancers and were null for vulvar, vaginal and oral cancers. The genomic similarities between HPV6/11 and HPV16 mainly involved the E7 gene, indicating a limited ability to block cell differentiation. The presence of single or dual HPV6/11 infections in variable proportions of penile and laryngeal cancers support the vaccination strategies that cover these genotypes, not only for preventing genital warts but also for cancer prevention. Other risk factors and co-carcinogens are likely to participate in epithelial carcinogenesis associated with low-risk HPV.
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Affiliation(s)
- Leandro Lima da Silva
- Post-Graduate Program in Adult Health (PPGSAD), Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil (A.P.A.d.S.); (H.O.B.)
| | - Amanda Mara Teles
- Post-Graduate Program in Adult Health (PPGSAD), Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil (A.P.A.d.S.); (H.O.B.)
- Post-Graduate Program in Animal Health, State University of Maranhão, São Luís 65099-110, MA, Brazil
| | - Joana M. O. Santos
- Molecular Oncology and Viral Pathology Group, Portuguese Institute of Oncology of Porto Research Center (CI-IPOP)/RISE@CI-IPOP (Health Research Network), Portuguese Institute of Oncology of Porto (IPO-Porto)/Porto Comprehensive Cancer Center (Porto.CCC), 4200-072 Porto, Portugal
| | - Marcelo Souza de Andrade
- Post-Graduate Program in Adult Health (PPGSAD), Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil (A.P.A.d.S.); (H.O.B.)
| | - Rui Medeiros
- Molecular Oncology and Viral Pathology Group, Portuguese Institute of Oncology of Porto Research Center (CI-IPOP)/RISE@CI-IPOP (Health Research Network), Portuguese Institute of Oncology of Porto (IPO-Porto)/Porto Comprehensive Cancer Center (Porto.CCC), 4200-072 Porto, Portugal
| | - Ana I. Faustino-Rocha
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal; (A.I.F.-R.)
- Inov4Agro—Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
| | - Paula A. Oliveira
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal; (A.I.F.-R.)
- Inov4Agro—Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
| | - Ana Paula Azevedo dos Santos
- Post-Graduate Program in Adult Health (PPGSAD), Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil (A.P.A.d.S.); (H.O.B.)
- Post-Graduate Program in Health Sciences, Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil
| | - Fernanda Ferreira Lopes
- Post-Graduate Program in Odontology, Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil;
| | - Geraldo Braz
- Post-Graduate Program in Computing Sciences, Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil;
| | - Haissa O. Brito
- Post-Graduate Program in Adult Health (PPGSAD), Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil (A.P.A.d.S.); (H.O.B.)
| | - Rui M. Gil da Costa
- Post-Graduate Program in Adult Health (PPGSAD), Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil (A.P.A.d.S.); (H.O.B.)
- Molecular Oncology and Viral Pathology Group, Portuguese Institute of Oncology of Porto Research Center (CI-IPOP)/RISE@CI-IPOP (Health Research Network), Portuguese Institute of Oncology of Porto (IPO-Porto)/Porto Comprehensive Cancer Center (Porto.CCC), 4200-072 Porto, Portugal
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal; (A.I.F.-R.)
- Inov4Agro—Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
- Laboratory for Process Engineering, Environment, Biotechnology and Energy (LEPABE), Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal
- Associate Laboratory in Chemical Engineering (ALiCE), Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal
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Robles-Silva C, Hidalgo L, Vera-Kellet C. Penile Intraepithelial Neoplasia: a Disease That Should Be Recognized. J Gen Intern Med 2023; 38:2205-2206. [PMID: 36988868 PMCID: PMC10361939 DOI: 10.1007/s11606-023-08150-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 03/09/2023] [Indexed: 03/30/2023]
Affiliation(s)
| | - Leonel Hidalgo
- Department of Dermatology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Cristián Vera-Kellet
- Department of Dermatology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
- Connective Tissue Diseases Unit, Department of Dermatology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna 4686. Macul, Santiago, Chile.
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Penile intraepithelial neoplasia: Distribution of subtypes, HPV genotypes and p16 INK4a in 84 international cases. Hum Pathol 2023; 131:1-8. [PMID: 36427594 DOI: 10.1016/j.humpath.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/16/2022] [Accepted: 11/16/2022] [Indexed: 11/25/2022]
Abstract
There are few pathologic or molecular studies of penile precancerous lesions, and the majority refers to lesions associated with invasive carcinomas. Penile Intraepithelial Neoplasia (PeIN) is classified in two morphologically and distinctive molecular groups, non-HPV and HPV-related with special subtypes. The primary purpose of this international series was to classify PeIN morphologically, detect HPV genotypes and determine their distribution according to PeIN subtypes. A secondary aim was to evaluate the p16INK4a immunostaining as a possible HPV surrogate for high-risk HPV infection in penile precancerous lesions. Samples consisted of 84 PeIN cases, part of a retrospective cross-sectional analysis of 1095 penile carcinomas designed to estimate the HPV DNA prevalence in penile cancers using PCR and p16INK4a immunostaining. Penile Intraepithelial Neoplasia (PeIN) was classified in HPV-related (basaloid, warty-basaloid, warty, hybrid, and mixed subtypes) and non-HPV-related (differentiated), the former being the most frequent. PeIN subtypes were differentiated (non-HPV-related) and basaloid, warty-basaloid, warty, hybrid and mixed (HPV-related). Basaloid PeIN was the most commonly diagnosed subtype, and HPV16 was the most frequent HPV genotype detected. Warty-basaloid and warty PeIN showed a more heterogeneous genotypic composition. Most HPV genotypes were high-risk but low-risk HPV genotypes were also present in a few cases (4%). A single HPV genotype was detected in 82% of HPV positive cases. In contrast, multiple genotypes were detected in the remaining 18% of cases. The findings in this study support the paradigm that penile in situ neoplasia, like its invasive counterparts, is HPV dependent or independent and has distinctive morphological subtypes readily identified in routine practice. Considering that HPV16 is clearly the predominant type, and that the three available vaccines have HPV16, all of them will be suitable for vaccination programs; the price of the vaccines will be probably the main determinant to choose the vaccine.
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Straub Hogan MM, Spieker AJ, Orejudos M, Gheit T, Herfs M, Tommasino M, Sanchez DF, Fernandez-Nestosa MJ, Pena MDCR, Gordetsky JB, Epstein JI, Canete-Portillo S, Gellert LL, Prieto Granada CN, Magi-Galluzzi C, Cubilla AL, Giannico GA. Pathological characterization and clinical outcome of penile intraepithelial neoplasia variants: a North American series. Mod Pathol 2022; 35:1101-1109. [PMID: 35190664 DOI: 10.1038/s41379-022-01020-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 11/08/2022]
Abstract
Penile intraepithelial neoplasia (PeIN) is classified as human papillomavirus (HPV)- and non-HPV-related. This classification is associated with distinct morphologic subtypes. The natural history and prognosis of PeIN subtypes are not well known. This study aims to evaluate clinicopathological features, HPV status, and outcome of PeIN subtypes. Eighty-two lesions from 64 patients with isolated PeIN were retrospectively reviewed. Mean age was 59 years. Lesions were multicentric in 34% of patients and affected glans (33%), shaft (26%), and foreskin (20%). Histologically, 22% of patients had coexisting lesions, classified as hybrid and mixed. HPV-related PeIN (97%) included basaloid (59%), warty (8%), warty-basaloid (8%), hybrid (19%) and mixed (3%) types. P16 and HPV positivity occurred in 99% and 82% of lesions, respectively. HPV 16 was more common in basaloid PeIN. Multiple genotypes were detected in 35%, more commonly in hybrid PeIN (P = 0.051). Positive margins occurred in 63% of excisions. PeIN recurred in 48% of excisions and 30% of overall repeated procedures, and progression to invasive carcinoma occurred in 2%. At follow-up, 86% of patients had no evidence of disease and 12% were alive with disease. Lichen sclerosus occurred in non-HPV and HPV-related PeIN (100% and 47%).In conclusion, HPV-related and, more specifically basaloid PeIN were the predominant types and preferentially associated with HPV 16. While PeIN had a high recurrence rate, there was a slow and infrequent progression to invasive or metastatic carcinoma with multimodal treatments. Additional studies are needed to understand biology and natural history of PeIN.
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Affiliation(s)
- Melissa M Straub Hogan
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Andrew J Spieker
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Michael Orejudos
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer, Lyon, France
| | - Michael Herfs
- Laboratory of Experimental Pathology, University of Liège, Liège, Belgium
| | - Massimo Tommasino
- Instituto de Patología e Investigación, Universidad Nacional de Asunción, Asunción, Paraguay
| | - Diego F Sanchez
- Instituto de Patología e Investigación, Universidad Nacional de Asunción, Asunción, Paraguay
- School of Medicine, National University of Asunción, San Lorenzo, Paraguay
| | | | | | - Jennifer B Gordetsky
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jonathan I Epstein
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | | | | | | | | | - Antonio L Cubilla
- Instituto de Patología e Investigación, Universidad Nacional de Asunción, Asunción, Paraguay
| | - Giovanna A Giannico
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA.
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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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Sindhuja T, Bhari N, Gupta S. Asian guidelines for condyloma acuminatum. J Infect Chemother 2022; 28:845-852. [PMID: 35341674 DOI: 10.1016/j.jiac.2022.03.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 02/16/2022] [Accepted: 03/08/2022] [Indexed: 11/18/2022]
Abstract
The present guidelines aim to provide comprehensive information on genital condyloma acuminata, including the epidemiology, clinical features, diagnosis and management. The guidelines provide evidence-based recommendations on the diagnosis, prevention and treatment of genital condyloma acuminata in adults in Asia, including patients with HIV co-infection. METHODOLOGY A PubMed search was performed, using the keywords "condyloma acuminata", "anal wart", "anogenital wart", "genital wart" and "genital HPV". A total of 3031 results were found in publications during last six years. A careful review of the titles and abstracts was done to find all the studies pertaining to epidemiology, clinical features, diagnosis, treatment and prevention of condyloma acuminata. DIAGNOSIS Various diagnostic procedures described are: 1. PCR (LE: 2b). 2. Serology (LE: 2b). 3. In-situ hybridization (LE: 3). PREVENTION 1. Vaccination (LE: 1a): Quadrivalent vaccine reduced the frequency of anogenital warts in both vaccinated and unvaccinated contacts. According to the update Advisory Committee on Immunization Practices (ACIP) recommendations, the following protocol is recommended: (a). HPV vaccination at age 11 or 12 years for both males and females. (b). Catch-up vaccination for all persons through age 26 years. (c). Shared clinical decision-making regarding potential HPV vaccination for persons aged 27-45 years, who are at risk of new HPV infection. 2. Male circumcision (LE: 2a): conflicting evidence. HIV AND CONDYLOMA ACUMINATA In HIV-affected individuals, the course of HPV is more aggressive, with a greater risk of treatment resistance, increased chances of intraepithelial neoplasia as well as cancers. TREATMENT Physician administered. 1. Photodynamic therapy (LE: 1a). 2. Laser (LE: 2b). 3. Surgery (LE: 1a). 4. Electrosurgery (LE: 2c). 5. Cryotherapy (LE: 1b). 6. Immunotherapy (LE: 1b). 7. Podophyllin (LE: 1b). Provider administered. 1. Imiquimod 5%(LE: 1a). 2. Podophyllotoxin (LE: 1b). 3. Sinecatechins (LE: 1a). 4. Cidofovir (LE: 3). 5. 5- Fluorouracil (LE: 1a). 6. Interferon (LE: 1a).
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Affiliation(s)
- Tekumalla Sindhuja
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Neetu Bhari
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Somesh Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.
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Pasmatzi E, Badavanis G, Kapranos N, Monastirli A, Apostolidou A, Tsambaos D. Condylomata acuminata, Bowenoid papulosis, and squamous cell carcinoma, all positive for human papillomavirus type 16/18 DNA, coexisting in the genital area: a case report. ACTA DERMATOVENEROLOGICA ALPINA PANNONICA ET ADRIATICA 2021. [DOI: 10.15570/actaapa.2021.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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10
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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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Hu Y, Hu E, Su X, Chen X, Tao X, Ren X. Molecular mechanism of microRNA-26a regulation of phosphatase and tensin homolog gene in condyloma acuminatum and penile squamous cell carcinoma. J Int Med Res 2021; 49:3000605211014379. [PMID: 34232796 PMCID: PMC8267046 DOI: 10.1177/03000605211014379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To investigate the expression levels and mechanisms of microRNA (miRNA) 26a (miR-26a) and phosphatase and tensin homolog (PTEN) in patients with human papillomavirus (HPV)-induced condyloma acuminatum (CA) and penile squamous cell carcinoma (PSCC). METHODS Thirty-one patients with HPV-positive CA and 28 with HPV-positive PSCC were included in this retrospective, cross-sectional study. PTEN mRNA and miR-26a levels in lesion tissues, blood, and urine were analyzed by quantitative reverse transcription polymerase chain reaction, and PTEN protein was detected by western blot and enzyme-linked immunosorbent assay. Cell proliferation was assessed by MTT assay. The interaction between miR-26a and PTEN was predicted by bioinformatics analysis and confirmed by dual luciferase reporter assay. RESULTS PTEN mRNA and protein levels were significantly lower and miR-26a levels were significantly higher in all samples from patients with PSCC compared with the CA group. Bioinformatics analysis and luciferase reporter assay confirmed PTEN as a target gene of miR-26a. Up-regulation of miR-26a significantly increased the proliferation of Penl1 PSCC cells. CONCLUSIONS PTEN expression is down-regulated and miR-26a levels are up-regulated in PSCC compared with CA. PTEN is a direct target gene of miR-26a. These results suggest that miR-26a might regulate HPV-positive progression from CA to PSCC through modulating PTEN.
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Affiliation(s)
- Yayu Hu
- Department of Dermatology, Taizhou Municipal Hospital, Taizhou, Zhejiang, China
| | - Enping Hu
- Department of Urology, Taizhou Municipal Hospital, Taizhou, Zhejiang, China
| | - Xiangchuan Su
- Department of Dermatology, Taizhou Municipal Hospital, Taizhou, Zhejiang, China
| | - Xiangen Chen
- Department of Dermatology, Taizhou Municipal Hospital, Taizhou, Zhejiang, China
| | - Xiulin Tao
- Department of Urology, Taizhou Municipal Hospital, Taizhou, Zhejiang, China
| | - Xiaoli Ren
- Department of Dermatology, Taizhou Municipal Hospital, Taizhou, Zhejiang, China
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12
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What Is New in the Pathologic Staging of Penile Carcinoma in the 8th Edition of AJCC TNM Model: Rationale for Changes With Practical Stage-by-stage Category Diagnostic Considerations. Adv Anat Pathol 2021; 28:209-227. [PMID: 34050061 DOI: 10.1097/pap.0000000000000297] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
For >50 years the tumor, node, metastasis (TNM) classification model of malignant tumors has been the main resource for clinicians, pathologists, radiologists and public health professionals ensuring a homogeneous classification and patients' management based on common staging and prognosis factors. Penile cancer was first included for staging in the third edition of the TNM classification with several changes in the last version, the 8th edition of the AJCC TNM Manual, in 2017. Some changes in the pT category were done due to recent knowledge regarding the prognostic importance of anatomical level of invasion, vascular and perineural invasion and tumor grading. These changes must be interpreted in the light of a required understanding of the complex anatomy of penile compartments especially their histological boundaries, the morphological differences of each level needed for the correct classification, the heterogeneity of penile squamous cell carcinomas and an adequate criticism of the current model used by the TNM system. We present here a series of stage-by-stage category diagnostic considerations based on the clinical experience acummulated over the years of applying the different TNM staging classifications in our large clinical practice. Some discrepancies will need well-designed prospective studies for im4proving the actual classification.
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13
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Erbersdobler A, Dräger D. [Non-invasive precursor lesions of penile carcinoma : Differential diagnosis and treatment]. Urologe A 2021; 60:895-900. [PMID: 34142169 DOI: 10.1007/s00120-021-01562-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2021] [Indexed: 12/01/2022]
Abstract
Clinical diagnosis of preinvasive malignant lesions of the penis is difficult and there are numerous differential diagnoses. Recent decades have been witness to several changes in the terminology of histopathological diagnoses. In the current World Health Organization classification, penile intraepithelial neoplasia (PeIN) is defined, of which several subtypes exist. Just like in invasive carcinoma, the principal classification of PeIN subtypes corresponds with pathogenesis and includes human papilloma virus (HPV)-related and non-HPV-related forms. Subdivision is important for prognosis. Several therapeutic options exist, including surgical and nonsurgical procedures.
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Affiliation(s)
- A Erbersdobler
- Institut für Pathologie, Universitätsmedizin Rostock, Strempelstr. 14, 18057, Rostock, Deutschland.
| | - D Dräger
- Urologische Klinik, Universitätsmedizin Rostock, Rostock, Deutschland
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14
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Sasidharanpillai S, Ravishankar N, Kamath V, Bhat PV, Bhatt P, Arunkumar G. Prevalence of Human Papillomavirus (HPV) DNA among Men with Oropharyngeal and Anogenital Cancers: A Systematic Review and Meta-Analysis. Asian Pac J Cancer Prev 2021; 22:1351-1364. [PMID: 34048162 PMCID: PMC8408381 DOI: 10.31557/apjcp.2021.22.5.1351] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 05/10/2021] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE The term ''Human Papillomavirus'' or ''HPV'' has become synonymous with uterine cervical cancer leading to feminisation of all the preventive measures, especially immunisation. Taking into consideration the rising number of HPV associated cancers among men in many developed countries and the risk of transmission to women, male HPV infection is a serious concern. A systematic review and meta-analysis of literature was performed to determine the global prevalence of HPV among men with oropharyngeal and anogenital cancers. METHODS A systematic review and meta-analysis of literature was performed searching electronic databases for published articles in English between January 1984- April 2020 based on standard systematic review guidelines. The meta-analysis component was modified appropriately for the synthesis of prevalence study results. National Institutes of Health checklist for observational, cohort and cross-sectional studies was used to assess the quality of the studies selected after the abstract and content review. The meta-analysis was performed in STATA version 13.0 (College Station, Texas 77,845 USA) and the forest plots were constructed using metan package in STATA. RESULTS Through the electronic search of databases, 3486 original articles were screened for eligibility. Fifty-eight articles were systematically reviewed and 42 articles were qualified for meta-analysis including 4,250 men with oropharyngeal, penile and prostate cancers. The pooled prevalence of HPV DNA in oropharyngeal cancers was 45% (95%CI 24.0%-66.0%). Meanwhile the pooled prevalence rates of 48% (CI 40.0%- 57.0%) and 19% (CI 10.0%-29.0%) were observed in penile and prostate cancers respectively. Even though, articles regarding HPV prevalence in anal cancers were systematically reviewed, none of the studies were qualified for meta-analysis. CONCLUSION Higher pooled prevalence of HPV DNA was observed among men with oropharyngeal and penile cancers. Multicentric molecular studies investigating the prevalence of HPV in prostate cancers have to be planned in future.
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Affiliation(s)
| | - Nagaraja Ravishankar
- Department of Biostatistics, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India.
| | - Veena Kamath
- Department of Community Medicine, Centre for Vaccine Studies-In Charge, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India.
| | - Parvati V Bhat
- Department of Obstetrics and Gynecology, Dr T M A Pai Hospital, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Puneet Bhatt
- Manipal Institute of Virology, Manipal Academy of Higher Education, Manipal, Karnataka, India.
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15
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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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16
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Medeiros-Fonseca B, Mestre VF, Estêvão D, Sánchez DF, Cañete-Portillo S, Fernández-Nestosa MJ, Casaca F, Silva S, Brito H, Félix A, Medeiros R, Colaço B, Oliveira PA, Bastos MM, Nelson PS, Vakar-Lopez F, Gaivão I, Brito L, Lopes C, Cubilla AL, Gil da Costa RM. HPV16 induces penile intraepithelial neoplasia and squamous cell carcinoma in transgenic mice: first mouse model for HPV-related penile cancer. J Pathol 2020; 251:411-419. [PMID: 32488868 DOI: 10.1002/path.5475] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 05/09/2020] [Accepted: 05/20/2020] [Indexed: 02/06/2023]
Abstract
Penile cancer is an under-studied disease that occurs more commonly in developing countries and 30-50% of cases show high-risk human papillomavirus (HPV) infection. Therapeutic advances are slow, largely due to the absence of animal models for translational research. Here, we report the first mouse model for HPV-related penile cancer. Ten-week-old mice expressing all the HPV16 early genes under control of the cytokeratin 14 (Krt14) gene promoter and matched wild-type controls were exposed topically to dimethylbenz(a)anthracene (DMBA) or vehicle for 16 weeks. At 30 weeks of age, mice were sacrificed for histological analysis. Expression of Ki67, cytokeratin 14, and of the HPV16 oncogenes E6 and E7 was confirmed using immunohistochemistry and quantitative PCR, respectively. HPV16-transgenic mice developed intraepithelial lesions including condylomas and penile intraepithelial neoplasia (PeIN). Lesions expressed cytokeratin 14 and the HPV16 oncogenes E6 and E7 and showed deregulated cell proliferation, demonstrated by Ki67-positive supra-basal cells. HPV16-transgenic mice exposed to DMBA showed increased PeIN incidence and squamous cell carcinoma. Malignant lesions showed varied histological features closely resembling those of HPV-associated human penile cancers. Wild-type mice showed no malignant or pre-malignant lesions even when exposed to DMBA. These observations provide the first experimental evidence to support the etiological role of HPV16 in penile carcinogenesis. Importantly, this is the first mouse model to recapitulate key steps of HPV-related penile carcinogenesis and to reproduce morphological and molecular features of human penile cancer, providing a unique in vivo tool for studying its biology and advancing basic and translational research. © 2020 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
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Affiliation(s)
| | - Verónica F Mestre
- CITAB, Universidade de Trás-os-Montes e Alto Douro, UTAD, Vila Real, Portugal
| | - Diogo Estêvão
- Grupo de Oncologia Molecular e Patologia Viral, CI-IPOP, IPO-Porto, Porto, Portugal.,Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Diego F Sánchez
- Instituto de Patología e Investigación and Universidad Nacional de Asunción, Asunción, Paraguay
| | - Sofía Cañete-Portillo
- Instituto de Patología e Investigación and Universidad Nacional de Asunción, Asunción, Paraguay
| | | | - Fátima Casaca
- Botelho Moniz Análises Clínicas (BMAC), Porto, Portugal
| | - Sandra Silva
- Botelho Moniz Análises Clínicas (BMAC), Porto, Portugal
| | - Haissa Brito
- Biobanco de Tumores e DNA do Maranhão, PPGSAD, Universidade Federal do Maranhão (UFMA), São Luís, Brazil
| | - Ana Félix
- Nova Medical School, Universidade Nova de Lisboa, Lisbon, Portugal.,Serviço de Anatomia Patológica, IPO-Lisboa, Lisbon, Portugal
| | - Rui Medeiros
- Grupo de Oncologia Molecular e Patologia Viral, CI-IPOP, IPO-Porto, Porto, Portugal.,Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,Serviço de Virologia, IPO-Porto, Porto, Portugal.,Liga Portuguesa Contra o Cancro - Núcleo Regional do Norte, Porto, Portugal.,CEBIMED, Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, Porto, Portugal
| | - Bruno Colaço
- CITAB, Universidade de Trás-os-Montes e Alto Douro, UTAD, Vila Real, Portugal.,Departamento de Zootecnia, Universidade de Trás-os-Montes e Alto Douro, UTAD, Vila Real, Portugal
| | - Paula A Oliveira
- CITAB, Universidade de Trás-os-Montes e Alto Douro, UTAD, Vila Real, Portugal.,Departamento de Ciências Veterinárias, Universidade de Trás-os-Montes e Alto Douro, UTAD, Vila Real, Portugal
| | | | - Peter S Nelson
- Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,University of Washington, Seattle, WA, USA
| | - Funda Vakar-Lopez
- LEPABE, Faculdade de Engenharia, Universidade do Porto, Porto, Portugal
| | - Isabel Gaivão
- CECAV and Department of Genetics and Biotechnology, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal
| | - Luciane Brito
- Biobanco de Tumores e DNA do Maranhão, PPGSAD, Universidade Federal do Maranhão (UFMA), São Luís, Brazil
| | - Carlos Lopes
- Botelho Moniz Análises Clínicas (BMAC), Porto, Portugal.,Grupo de Patologia Experimental, Ci-IPOP, IPO-Porto, Porto, Portugal.,Departamento de Patologia e Imunologia Molecular, ICBAS, Universidade do Porto, Porto, Portugal
| | - Antonio L Cubilla
- Instituto de Patología e Investigación and Universidad Nacional de Asunción, Asunción, Paraguay
| | - Rui M Gil da Costa
- CITAB, Universidade de Trás-os-Montes e Alto Douro, UTAD, Vila Real, Portugal.,Grupo de Oncologia Molecular e Patologia Viral, CI-IPOP, IPO-Porto, Porto, Portugal.,Biobanco de Tumores e DNA do Maranhão, PPGSAD, Universidade Federal do Maranhão (UFMA), São Luís, Brazil.,LEPABE, Faculdade de Engenharia, Universidade do Porto, Porto, Portugal.,Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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17
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Bilateral inguinal HPV-related squamous cell carcinomas with warty-basaloid features: An unusual presentation in a non-penile location. CURRENT PROBLEMS IN CANCER: CASE REPORTS 2020. [DOI: 10.1016/j.cpccr.2020.100036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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18
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Sanchez DF, Fernandez-Nestosa MJ, Cañete-Portillo S, Cubilla AL. Evolving insights into penile cancer pathology and the eighth edition of the AJCC TNM staging system. Urol Oncol 2020; 40:215-222. [PMID: 33008752 DOI: 10.1016/j.urolonc.2020.09.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 08/19/2020] [Accepted: 09/13/2020] [Indexed: 01/30/2023]
Abstract
The majority of penile malignant tumors are squamous cell carcinomas. They are pathologically defined as epithelial neoplasms originating in the squamous cells of the inner mucosal lining of the glans, coronal sulcus or foreskin. Tumor location and site of origin is preferentially in glans (70%) followed by foreskin (25%) and coronal sulcus (5%). Despite the variable geographic distribution, pathological features of penile carcinomas in areas of high- and low-risk are similar. Penile tumors are morphologically heterogeneous. A major advance, based on biological, etiological and prognostic factors, is the 2016 WHO classification separating epithelial penile neoplasia, precancerous and invasive, in non-HPV and HPV-related.
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Affiliation(s)
- Diego F Sanchez
- Instituto de Patología e Investigación, Asunción, Paraguay; School of Medicine, National University of Asuncion, San Lorenzo, Paraguay
| | - Maria Jose Fernandez-Nestosa
- Instituto de Patología e Investigación, Asunción, Paraguay; Polytechnic School, National University of Asunción, San Lorenzo, Paraguay
| | | | - Antonio L Cubilla
- Instituto de Patología e Investigación, Asunción, Paraguay; School of Medicine, National University of Asuncion, San Lorenzo, Paraguay.
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19
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Kravvas G, Ge L, Ng J, Shim TN, Doiron PR, Watchorn R, Kentley J, Panou E, Dinneen M, Freeman A, Jameson C, Haider A, Francis N, Minhas S, Alnajjar H, Muneer A, Bunker CB. The management of penile intraepithelial neoplasia (PeIN): clinical and histological features and treatment of 345 patients and a review of the literature. J DERMATOL TREAT 2020; 33:1047-1062. [DOI: 10.1080/09546634.2020.1800574] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- G. Kravvas
- Department of Dermatology, University College London Hospitals, London, UK
| | - L. Ge
- Department of Dermatology, University College London Hospitals, London, UK
| | - J. Ng
- Department of Dermatology, Chelsea & Westminster Hospital, London, UK
| | - T. N. Shim
- Department of Dermatology, University College London Hospitals, London, UK
| | - P. R. Doiron
- Department of Dermatology, University College London Hospitals, London, UK
| | - R. Watchorn
- Department of Dermatology, University College London Hospitals, London, UK
| | - J. Kentley
- Department of Dermatology, Chelsea & Westminster Hospital, London, UK
| | - E. Panou
- Department of Dermatology, University College London Hospitals, London, UK
| | - M. Dinneen
- Department of Urology, Chelsea & Westminster Hospital, London, UK
| | - A. Freeman
- Department of Histopathology, University College London Hospitals, London, UK
| | - C. Jameson
- Department of Histopathology, University College London Hospitals, London, UK
| | - A. Haider
- Department of Histopathology, University College London Hospitals, London, UK
| | - N. Francis
- Department of Histopathology, Imperial College Hospitals, London, UK
| | - S. Minhas
- Department of Urology, Imperial College Hospitals, London, UK
| | - H. Alnajjar
- Department of Urology, University College London Hospitals, London, UK
| | - A. Muneer
- Department of Urology, University College London Hospitals, London, UK
| | - C. B. Bunker
- Department of Dermatology, University College London Hospitals, London, UK
- Department of Dermatology, Chelsea & Westminster Hospital, London, UK
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20
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Report From the International Society of Urological Pathology (ISUP) Consultation Conference on Molecular Pathology of Urogenital Cancers V. Am J Surg Pathol 2020; 44:e80-e86. [DOI: 10.1097/pas.0000000000001477] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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21
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Martínez-Bailón C, Mantilla-Morales A, Méndez-Matías G, Alvarado-Cabrero I, Maldonado-Rodríguez R, Quintero-Becerra J, Arias-Flores R, Piña-Sánchez P. Human papillomavirus genotypes and P16INK4A expression in squamous penile carcinoma in Mexican patients. BMC Infect Dis 2019; 19:1068. [PMID: 31856740 PMCID: PMC6924036 DOI: 10.1186/s12879-019-4696-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 12/09/2019] [Indexed: 01/22/2023] Open
Abstract
Background Approximately 50% of cases of penile carcinoma (PeCa), a rare neoplasm worldwide, are associated with human papillomavirus (HPV). However, the detection of HPV-DNA is not sufficient to consider it the etiological factor in the development of this type of cancer. Currently, the overexpression of P16INK4A is used as a surrogate biomarker of HPV carcinogenesis. Information on PeCa in Mexico is scarce, particularly regarding cases related to HPV and genotype frequency. Objective To evaluate the presence of HPV, its genotypes, and the presence of multiple genotypes, and the expression of P16INK4A, as well as its clinical and histopathological parameters. Methods For HPV-DNA detection and P16INK4A expression, we used the INNO-LiPA® test and immunohistochemistry, respectively. Results Sixty cases of PeCa were evaluated, of which 75% were HPV-non-related histological variants. We found that 58.9% (33/56) of PeCa cases were HPV-DNA positive, while 30.9% of the cases evaluated (17/55) were positive for P16INK4A. HPV16 was the main genotype in 42.9% of the cases, followed by HPV52 in 7.1% and HPV18 in 5.4%. Within the HPV-positive cases, 27.3% had multiple genotypes. All HPV-positive patients under the age of 45 years were positive only for HPV16. Conclusions HPV16 was the most commonly detected genotype in PeCa. HPV 31, 35 and 39 were infrequent; however, they were related to a single infection and P16INK4A overexpression; thus, they seem to be relevant in PeCa carcinogenesis. Our results suggest that P16INK4A overexpression could be useful for the classification of HPV-related PeCa. The role of multiple HPV genotypes in the development and prognosis of PeCa is still not completely understood. Thus, it is necessary to define criteria to establish reliable ways to classify HPV-related PeCa that could lead to optimal therapeutic approaches.
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Affiliation(s)
- Cecilia Martínez-Bailón
- Molecular Oncology Laboratory, Oncology Research Unit, Instituto Mexicano del Seguro Social, CMN S XXI IMSS, Mexico City, Mexico
| | - Alejandra Mantilla-Morales
- Department of Pathology, UMAE Oncology Hospital, Instituto Mexicano del Seguro Social, CMN S XXI IMSS, Mexico City, Mexico
| | - Galo Méndez-Matías
- Molecular Oncology Laboratory, Oncology Research Unit, Instituto Mexicano del Seguro Social, CMN S XXI IMSS, Mexico City, Mexico
| | - Isabel Alvarado-Cabrero
- Department of Pathology, UMAE Oncology Hospital, Instituto Mexicano del Seguro Social, CMN S XXI IMSS, Mexico City, Mexico
| | - Rogelio Maldonado-Rodríguez
- Department of Biochemistry, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico
| | - Joel Quintero-Becerra
- Department of Urology, UMAE Oncology Hospital, Instituto Mexicano del Seguro Social, CMN S XXI, Mexico City, Mexico
| | - Rafael Arias-Flores
- Department of Epidemiology, UMAE Pediatrics Hospital, Instituto Mexicano del Seguro Social, CMN S XXI, Mexico City, Mexico
| | - Patricia Piña-Sánchez
- Molecular Oncology Laboratory, Oncology Research Unit, Instituto Mexicano del Seguro Social, CMN S XXI IMSS, Mexico City, Mexico.
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Fernández-Nestosa MJ, Guimerà N, Sanchez DF, Cañete-Portillo S, Lobatti A, Velazquez EF, Jenkins D, Quint W, Cubilla AL. Comparison of Human Papillomavirus Genotypes in Penile Intraepithelial Neoplasia and Associated Lesions: LCM-PCR Study of 87 Lesions in 8 Patients. Int J Surg Pathol 2019; 28:265-272. [PMID: 31735112 DOI: 10.1177/1066896919887802] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Penile intraepithelial neoplasia (PeIN) is currently classified in human papillomavirus (HPV)- and non-HPV-related subtypes with variable HPV genotypes. PeINs are frequently associated with other intraepithelial lesions in the same specimen. The aim of this study was to detect and compare HPV genotypes in PeINs and associated lesions using high-precision laser capture microdissection-polymerase chain reaction and p16INK4a immunostaining. We evaluated resected penile specimens from 8 patients and identified 33 PeINs and 54 associated lesions. The most common subtype was warty PeIN, followed by warty-basaloid and basaloid PeIN. Associated lesions were classical condylomas (17 cases), atypical classical condylomas (2 cases), flat condylomas (9 cases), atypical flat condylomas (6 cases), flat lesions with mild atypia (12 cases), and squamous hyperplasia (8 cases). After a comparison, identical HPV genotypes were found in PeIN and associated lesions in the majority of the patients (7 of 8 patients). HPV16 was the most common genotype present in both PeIN and corresponding associated lesion (50% of the patients). Nonspecific flat lesions with mild atypia, classical condylomas, and atypical condylomas were the type of associated lesions most commonly related to HPV16. Other high-risk HPV genotypes present in PeIN and associated nonspecific flat lesion with mild atypia were HPV35 and HPV39. In this study of HPV in the microenvironment of penile precancerous lesions, we identified identical high-risk HPV genotypes in PeIN and classical, flat, or atypical condylomas and, specially, in nonspecific flat lesions with mild atypia. It is possible that some of these lesions represent hitherto unrecognized precancerous lesions.
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Affiliation(s)
| | | | | | | | | | | | | | - Wim Quint
- DDL Diagnostic Laboratory, Rijswijk, Netherlands
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23
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Pathology of Invasive and Intraepithelial Penile Neoplasia. Eur Urol Focus 2019; 5:713-717. [PMID: 31288989 DOI: 10.1016/j.euf.2019.06.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 05/10/2019] [Accepted: 06/21/2019] [Indexed: 11/23/2022]
Abstract
Since 1995 it has been known that tumors harboring human papillomavirus (HPV) preferentially show basaloid or condylomatous histological features, while HPV-negative tumors have a different morphology. New classification models separate subtypes of penile squamous cell carcinomas in two groups, non-HPV- and HPV-related. It is purported that HPV-related tumors have better prognosis. Other features such as inflammatory cell-rich medullary, clear-cell, and lymphoepithelioma-like patterns are also strong predictors of the presence of HPV. These tumors are morphologically distinctive and with some experience, pathologists may recognize them after routine hematoxylin and eosin staining. Occasionally, p16 immunostaining may aid in differential diagnosis. The gold standard for HPV detection is polymerase chain reaction, but this technique is expensive and not available in most pathology laboratories. In situ hybridization is useful and p16 immunostaining can detect HPV in approximately 85% of cases. There is correlation between morphology and outcome. PATIENT SUMMARY: This mini review provides an overview of the latest classification for penile invasive carcinoma and penile intraepithelial neoplasia.
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Chin-Hong PV, Reid GE. Human papillomavirus infection in solid organ transplant recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant 2019; 33:e13590. [PMID: 31077438 DOI: 10.1111/ctr.13590] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 05/06/2019] [Indexed: 02/06/2023]
Abstract
These guidelines from the American Society of Transplantation Infectious Diseases Community of Practice update the epidemiology and management of human papillomavirus (HPV) infections in organ transplant recipients. HPV is one of the most common sexually transmitted infections and is associated with cancers of the anogenital region. Increasing evidence suggests an association with head and neck cancers as well. Solid organ transplant recipients have a higher risk of HPV infection than the general population. Infection manifests as premalignant lesions, warts, or cancer of the cervix, penis, vulva, scrotum, and anal canal. Most are asymptomatic initially, so diagnosis can be difficult without screening. A vaccine is available though not effective in preventing all cancer-causing strains. Organ transplant recipients should be screened for HPV-associated cancers and appropriate therapy initiated in a timely manner. Further studies are warranted to delineate the most effective screening methods and therapeutic modalities, including whether changes in immunosuppression are effective in attenuating disease.
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Affiliation(s)
- Peter V Chin-Hong
- Division of Infectious Diseases, University of California at San Francisco, San Francisco, California
| | - Gail E Reid
- Division of Infectious Diseases, Loyola University Medical Center, Maywood, Illinois
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25
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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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26
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Martins VDA, Pinho JD, Teixeira Júnior AAL, Nogueira LR, Silva FF, Maulen VE, Khayat AS, Calixto JDRR, Costa HA, Ramalho LNZ, Silva GEB. P16INK4a expression in patients with penile cancer. PLoS One 2018; 13:e0205350. [PMID: 30312320 PMCID: PMC6185731 DOI: 10.1371/journal.pone.0205350] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 09/24/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Infection with human papillomavirus (HPV) is reported to be present in 30-50% of penile cancer cases. The immunohistochemical test for p16INK4a is used as an indicator of the presence of HPV and as a prognostic marker for squamous cell carcinomas in various sites. However, the role of this marker in penile carcinoma has not yet been completely elucidated. The aim of this study was to analyze whether the expression of p16INK4a is associated with the presence of HPV, histological parameters, and survival in penile cancer. METHODS A study was conducted from 2014 to 2016 that included 55 patients with penile carcinoma. HPV DNA was detected through PCR using fresh tumor tissue, and immunohistochemistry was performed for analysis of p16INK4a protein using paraffin-embedded tissue. Evaluation of histological parameters was performed following complete embedding of the tumor tissue in paraffin. RESULTS HPV DNA (low-risk and high-risk genotypes) was found in 49 (89.1%) cases, and 46/49 (93.9%) showed high-oncogenic risk HPV (HR-HPV). Of the 22 cases positive for p16INK4a, HR-HPV DNA was present in 21 (95.5%) (p = 0.032). Regarding histological parameters, p16INK4a and HR-HPV were significantly associated only with tumor subtype (p = 0.036 and p = 0.032, respectively); all carcinomas with basaloid characteristics were positive for p16INK4a. Although HPV+ patients had a higher disease-free survival (p <0.001), p16INK4a expression was not associated with patient survival. CONCLUSIONS Our study, using fresh tissue samples, showed the highest incidence of HPV compared to that observed in the literature. Expression of the p16INK4a protein was significantly associated with the presence of HR-HPV and this expression may serve as a marker for the presence of the virus. The p16INK4a protein was not associated with the histological prognostic parameters, with the exception of tumor subtype, nor with patient survival. In the results, we showed that the objective of the present study was reached.
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Affiliation(s)
- Vicenilma de Andrade Martins
- Postgraduate Program in Adult and Child Health (PPGSAC), Federal University of Maranhão (UFMA), São Luís, Brazil
| | - Jaqueline Diniz Pinho
- Postgraduate Program in Genetics and Molecular Biology (PPGBM), Federal University of Pará (UFPA), Belém, Brazil
| | | | | | - Fábio França Silva
- Northeast Network of Biotechnology Program (RENORBIO), State University of Ceará (UECE), Ceará, Brazil
| | | | - André Salim Khayat
- Postgraduate Program in Genetics and Molecular Biology (PPGBM), Federal University of Pará (UFPA), Belém, Brazil
| | | | - Herikson Araújo Costa
- Department of Physical Education, Federal University of Maranhão (UFMA), Pinheiro, Brazil
| | | | - Gyl Eanes Barros Silva
- Department of Pathology, Ribeirão Preto Medical of School, University of São Paulo (USP), Ribeirao Preto, Brazil
- * E-mail:
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27
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Ao C, Zeng K. The role of regulatory T cells in pathogenesis and therapy of human papillomavirus-related diseases, especially in cancer. INFECTION GENETICS AND EVOLUTION 2018; 65:406-413. [PMID: 30172014 DOI: 10.1016/j.meegid.2018.08.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 08/13/2018] [Accepted: 08/15/2018] [Indexed: 12/19/2022]
Abstract
Human papillomavirus (HPV) is the most common sexually transmitted agent in the world. It can cause condyloma acuminatum, anogenital malignancies, and head and neck cancers. The host immune responses to HPV involve multiple cell types that have regulatory functions, and HPV-mediated changes to regulatory T cells (Tregs) in both the local lesion tissues and the circulatory system of patients have received considerable attention. The role of Tregs in HPV infections ranges from suppression of effector T cell (Teff) responses to protection of tissues from immune-mediated injury in different anatomic subsites. In this review, we explore the influence of Tregs in the immunopathology of HPV-related diseases and therapies targeting Tregs as novel approaches against HPV.
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Affiliation(s)
- Chunping Ao
- Department of Dermatology and Venereology, Nanfang hospital, Southern Medical University, Guangzhou, 510515, China
| | - Kang Zeng
- Department of Dermatology and Venereology, Nanfang hospital, Southern Medical University, Guangzhou, 510515, China.
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28
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Dauendorffer JN, Renaud-Vilmer C, Cavelier Balloy B, Meria P, Desgrandchamps F, Bagot M. [Penile intra-epithelial neoplasia]. Prog Urol 2018; 28:466-474. [PMID: 29937064 DOI: 10.1016/j.purol.2018.05.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 04/20/2018] [Accepted: 05/18/2018] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Penile intra-epithelial neoplasia (PIN) are precancerous lesions, characterized by architectural and cytological abnormalities of the genital epithelium, from which can arise squamous carcinomas. METHODS A literature review was performed on the Medline database, considering the articles listed between October 2007 and October 2017 dealing with PIN, using the following keywords "intraepithelial neoplasia" or "Bowen's disease" or "erythroplasia of Queyrat" or "bowenoid papulosis" and "penis ». Papers were selected according to their language (English and French) and their relevance. RESULTS One hundred seventy four articles related to PIN were listed. Twenty-five of them were selected for their relevance. The analysis of the references of these articles identified 6 relevant papers published before October 2007, which were considered for this review based on a total of thirty-one articles. We describe clinical and pathological characteristics of PIN, emphasizing treatment modalities. CONCLUSION Urologists should distinguish HPV-related and non HPV-related PIN, both of them sharing clinical presentation, but needing different management.
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Affiliation(s)
- J N Dauendorffer
- Service de dermatologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France.
| | - C Renaud-Vilmer
- Service de dermatologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - B Cavelier Balloy
- Service d'anatomopathologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - P Meria
- Service d'urologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - F Desgrandchamps
- Service d'urologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - M Bagot
- Service de dermatologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
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Human papillomavirus 16 is an aetiological factor of scrotal cancer. Br J Cancer 2017; 116:1218-1222. [PMID: 28376081 PMCID: PMC5418448 DOI: 10.1038/bjc.2017.74] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 02/23/2017] [Accepted: 03/01/2017] [Indexed: 01/21/2023] Open
Abstract
Background: Squamous cell scrotal carcinoma (SCSC) is an infrequent skin cancer associated historically with occupational carcinogens. Human papillomavirus (HPV) DNA has been associated with SCSC but there is no definitive proof of its oncogenic role. Methods: Human papillomavirus-DNA and –E6*I mRNA were analysed in six invasive histologically typed SCSC. LCM-PCR was used to localise HPV DNA to tumour cells. P16INK4aand p53 expression were studied by immunohistochemistry. Results: In three warty or basaloid SCSC HPV16-DNA and E6*I-mRNA were detected. LCM-PCR confirmed HPV16 was in p16INK4a-positive malignant cells. However, of three usual-type SCSC, all were HPV-negative and two expressed p53 protein but not p16INK4a. Conclusions: Human papillomavirus 16 was present in tumour cells and oncogenically active in basaloid and warty SCSC, whereas usual SCSC was HPV-negative and showed immunostaining, suggesting p53 mutation. The dual pathways of oncogenesis and relation between histological type of SCSC and HPV are similar to that in penile cancers.
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