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Wei L, Huang K, Han H, Liu RY. Human Papillomavirus Infection in Penile Cancer: Multidimensional Mechanisms and Vaccine Strategies. Int J Mol Sci 2023; 24:16808. [PMID: 38069131 PMCID: PMC10706305 DOI: 10.3390/ijms242316808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/19/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
Penile cancer (PC) is a rare male malignant tumor, with early lymph node metastasis and poor prognosis. Human papillomavirus (HPV) plays a key role in the carcinogenesis of PC. This review aims to summarize the association between HPV infection and PC in terms of virus-host genome integration patterns (the disrupted regions in the HPV and PC genome), genetic alterations, and epigenetic regulation (methylation and microRNA modification) occurring in HPV and PC DNA, as well as tumor immune microenvironment reprogramming. In addition, the potential of HPV vaccination strategies for PC prevention and treatment is discussed. Understanding of the HPV-related multidimensional mechanisms and the application of HPV vaccines will promote rational and novel management of PC.
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Affiliation(s)
- Lichao Wei
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, China; (L.W.); (K.H.)
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Kangbo Huang
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, China; (L.W.); (K.H.)
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Hui Han
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, China; (L.W.); (K.H.)
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Ran-yi Liu
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, China; (L.W.); (K.H.)
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Penile Focal Erythematous Macules and Patches: Answer. Am J Dermatopathol 2023; 45:273-274. [PMID: 36921304 DOI: 10.1097/dad.0000000000002376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
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3
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The molecular pathogenesis of penile carcinoma—current developments and understanding. Virchows Arch 2019; 475:397-405. [DOI: 10.1007/s00428-019-02607-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 05/30/2019] [Accepted: 06/10/2019] [Indexed: 12/11/2022]
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4
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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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Adimonye A, Stankiewicz E, Touche SL, Kudahetti S, Tinwell B, Corbishley C, Lu YJ, Watkin N, Berney D. The Prognostic Value of PIK3CA Copy Number Gain in Penile Cancer. Urology 2018:S0090-4295(18)30560-0. [PMID: 30031830 DOI: 10.1016/j.urology.2018.03.056] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 03/08/2018] [Accepted: 03/22/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To determine whether phosphatidylinositol-4,5-bisphosphate 3- kinase, catalytic subunit alpha (PIK3CA) copy number gain in penile cancer has prognostic value and association with histopathological parameters, human papillomavirus (HPV), and clinical outcome. METHODS PIK3CA copy number status was assessed with fluorescence in situ hybridization in tissue microarrays generated from archival paraffin embedded blocks of 199 patients with primary penile squamous cell carcinoma (PSCC). HPV DNA was detected with INNO-LiPA assay. Follow-up data were available for 174 patients. PIK3CA copy number status was correlated with histopathological parameters, high-risk HPV, cancer-specific survival and time to recurrence. RESULTS PIK3CA copy number gain was found in 84/199 (42%) of penile cancer cases. PIK3CA copy number gain was associated with tumor subtype, grade, and stage (P = .0028, P < .0001, and P = .0397, respectively), but not with lymph node status (P = .2902). PIK3CA copy number gain showed a tendency to associate with cancer-specific survival (HR = 1.76, 95% CI; 0.94-3.3; P = .0753). In multivariate analysis, PIK3CA copy number gain was found to have no prognostic value for cancer-specific survival (P = .677). Only lymph node metastasis, high tumor grade and stage were found to be independent prognostic factors for cancer-specific survival. CONCLUSION PIK3CA copy number gain could be used as a marker of high-risk disease as it correlates with more aggressive PSCC histological subtypes and higher tumor grade and stage. However, it shows no significant association with lymph node metastasis or prognostic value for cancer-specific survival in PSCC.
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Affiliation(s)
- Anthony Adimonye
- Barts Cancer Institute, Centre for Molecular Oncology, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.
| | - Elzbieta Stankiewicz
- Barts Cancer Institute, Centre for Molecular Oncology, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Susannah La Touche
- Barts Cancer Institute, Centre for Molecular Oncology, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Sakunthala Kudahetti
- Barts Cancer Institute, Centre for Molecular Oncology, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Brendan Tinwell
- Department of Cellular Pathology, St George's Hospital, London, United Kingdom
| | - Cathy Corbishley
- Department of Cellular Pathology, St George's Hospital, London, United Kingdom
| | - Yong-Jie Lu
- Barts Cancer Institute, Centre for Molecular Oncology, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Nick Watkin
- Department of Urology, St George's Hospital, London, United Kingdom
| | - Daniel Berney
- Barts Cancer Institute, Centre for Molecular Oncology, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
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HPV-negative penile squamous cell carcinoma: disruptive mutations in the TP53 gene are common. Mod Pathol 2017; 30:1013-1020. [PMID: 28387325 DOI: 10.1038/modpathol.2017.26] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 02/16/2017] [Accepted: 02/19/2017] [Indexed: 12/24/2022]
Abstract
The majority of penile squamous cell carcinomas is caused by transforming human papilloma virus (HPV) infection. The etiology of HPV-negative cancers is unclear, but TP53 mutations have been implicated. Archival tissues of 108 invasive squamous cell carcinoma from a single pathology institution in a low-incidence area were analyzed for HPV-DNA and p16ink4a overexpression and for TP53 mutations by ion torrent next-generation sequencing. Library preparation failed in 32/108 squamous cell carcinomas. Institutional review board approval was obtained. Thirty of 76 squamous cell carcinomas (43%; average 63 years) were HPV-negative with 8/33 squamous cell carcinomas being TP53 wild-type (24%; average 63 years). Twenty-five of 33 squamous cell carcinomas (76%; average 65 years) showed 32 different somatic TP53 mutations (23 missense mutations in exons 5-8, 6 nonsense, 1 frameshift and 2 splice-site mutations). Several hotspot mutations were detected multiple times (R175H, R248, R282, and R273). Eighteen of 19 squamous cell carcinomas with TP53 expression in immunohistochemistry had TP53 mutations. Fifty percent of TP53-negative squamous cell carcinomas showed mostly truncating loss-of-function TP53 mutations. Patients without mutations had longer survival (5 years: 86% vs 61%; 10 years: 60% vs 22%), but valid clinically relevant conclusions cannot be drawn due to different tumor stages and heterogeneous treatment of the cases presented in this study. Somatic TP53 mutations are a common feature in HPV-negative penile squamous cell carcinomas and offer an explanation for HPV-independent penile carcinogenesis. About half of HPV-negative penile cancers are driven by oncogenic activation of TP53, while a quarter is induced by loss of TP53 tumor suppressor function. Detection of TP53 mutations should be carried out by sequencing, as immunohistochemical TP53 staining could not identify all squamous cell carcinomas with TP53 mutations.
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Abstract
Penile squamous cell carcinoma (PSCC) is a rare cancer, but is more common in developing countries. Locally advanced and metastatic PSCC is associated with significant morbidity and mortality, with the prognosis remaining extremely poor. The authors searched PubMed and published abstracts for metastatic PSCC studies to describe emerging therapies. Multimodality treatment using chemotherapy, radiation, and consolidative surgery are standard of care. Utilizing anti-EGFR therapies and novel immunotheraputic approaches may help improve outcomes in PSCC.
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Affiliation(s)
- Shilpa Gupta
- Department of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN 55455, USA
| | - Guru Sonpavde
- Section of Medical Oncology, Department of Medicine, UAB Comprehensive Cancer Center, 1802 6th Avenue South, NP2540B, Birmingham, AL 35294, USA.
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9
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Erbersdobler A. Pathologic Evaluation and Reporting of Carcinoma of the Penis. Clin Genitourin Cancer 2016; 15:192-195. [PMID: 27594553 DOI: 10.1016/j.clgc.2016.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 08/01/2016] [Indexed: 10/21/2022]
Abstract
Carcinoma of the penis is a rare tumor in the United States and in western European countries. Clinical management has become more complex in recent years, because organ-preserving strategies are being favored. Furthermore, our understanding of the pathogenesis of this malignancy has grown considerably. As a result of these developments, the demands on the pathology reports of surgical specimens from the penis have increased. There are also some peculiarities with the current World Health Organization and TNM classification systems of penile cancer as compared with other tumor entities. This review outlines the most relevant aspects that have to be considered in the pathologic handling and typing of penile carcinoma.
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10
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La-Touche S, Lemetre C, Lambros M, Stankiewicz E, Ng CKY, Weigelt B, Rajab R, Tinwell B, Corbishley C, Watkin N, Berney D, Reis-Filho JS. DNA Copy Number Aberrations, and Human Papillomavirus Status in Penile Carcinoma. Clinico-Pathological Correlations and Potential Driver Genes. PLoS One 2016; 11:e0146740. [PMID: 26901676 PMCID: PMC4763861 DOI: 10.1371/journal.pone.0146740] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 12/21/2015] [Indexed: 12/11/2022] Open
Abstract
Penile squamous cell carcinoma is a rare disease, in which somatic genetic aberrations have yet to be characterized. We hypothesized that gene copy aberrations might correlate with human papillomavirus status and clinico-pathological features. We sought to determine the spectrum of gene copy number aberrations in a large series of PSCCs and to define their correlations with human papillomavirus, histopathological subtype, and tumor grade, stage and lymph node status. Seventy formalin-fixed, paraffin embedded penile squamous cell carcinomas were centrally reviewed by expert uropathologists. DNA was extracted from micro-dissected samples, subjected to PCR-based human papillomavirus assessment and genotyping (INNO-LiPA human papillomavirus Genotyping Extra Assay) and microarray-based comparative genomic hybridization using a 32K Bacterial Artificial Chromosome array platform. Sixty-four samples yielded interpretable results. Recurrent gains were observed in chromosomes 1p13.3-q44 (88%), 3p12.3-q29 (86%), 5p15.33-p11 (67%) and 8p12-q24.3 (84%). Amplifications of 5p15.33-p11 and 11p14.1-p12 were found in seven (11%) and four (6%) cases, respectively. Losses were observed in chromosomes 2q33-q37.3 (86%), 3p26.3-q11.1 (83%) and 11q12.2-q25 (81%). Although many losses and gains were similar throughout the cohort, there were small significant differences observed at specific loci, between human papillomavirus positive and negative tumors, between tumor types, and tumor grade and nodal status. These results demonstrate that despite the diversity of genetic aberrations in penile squamous cell carcinomas, there are significant correlations between the clinico-pathological data and the genetic changes that may play a role in disease natural history and progression and highlight potential driver genes, which may feature in molecular pathways for existing therapeutic agents.
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Affiliation(s)
- Susannah La-Touche
- Bart's Cancer Institute, Centre for Molecular Oncology, Queen Mary University of London, John Vane Science Centre, Charterhouse square, London, United Kingdom
- * E-mail:
| | - Christophe Lemetre
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York, United States of America
| | - Maryou Lambros
- Molecular Pathology, Institute of Cancer Research, London, United Kingdom
| | - Elzbieta Stankiewicz
- Bart's Cancer Institute, Centre for Molecular Oncology, Queen Mary University of London, John Vane Science Centre, Charterhouse square, London, United Kingdom
| | - Charlotte K. Y. Ng
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York, United States of America
| | - Britta Weigelt
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York, United States of America
| | - Ramzi Rajab
- St George’s Hospital, Tooting, London, United Kingdom
| | | | | | - Nick Watkin
- St George’s Hospital, Tooting, London, United Kingdom
| | - Dan Berney
- Bart's Cancer Institute, Centre for Molecular Oncology, Queen Mary University of London, John Vane Science Centre, Charterhouse square, London, United Kingdom
| | - Jorge S. Reis-Filho
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York, United States of America
- Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York, United States of America
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11
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Downes MR. Review of in situ and invasive penile squamous cell carcinoma and associated non-neoplastic dermatological conditions. J Clin Pathol 2015; 68:333-40. [PMID: 25883161 DOI: 10.1136/jclinpath-2015-202911] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Penile carcinoma is a rare genitourinary malignancy in North America and Europe with highest rates recorded in South America, Africa and Asia. Recent classifications have refined the terminology used in classifying intraepithelial/in situ lesions and additionally newer entities have been recognised in the invasive category. While increasing recognition of a bimodal pathway of penile carcinogenesis has facilitated understanding and classification of these tumours, handling and subtyping of penile malignancies presents a challenge to the reporting pathologist, in part due to their rarity. This article reviews the terminology and classification of in situ and invasive carcinomas and their relationship to human papilloma virus status. In addition, associated non-neoplastic dermatological conditions of relevance and appropriate ancillary investigations will be addressed.
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Busso-Lopes AF, Marchi FA, Kuasne H, Scapulatempo-Neto C, Trindade-Filho JCS, de Jesus CMN, Lopes A, Guimarães GC, Rogatto SR. Genomic profiling of human penile carcinoma predicts worse prognosis and survival. Cancer Prev Res (Phila) 2014; 8:149-56. [PMID: 25502573 DOI: 10.1158/1940-6207.capr-14-0284] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The molecular mechanisms underlying penile carcinoma are still poorly understood, and the detection of genetic markers would be of great benefit for these patients. In this study, we assessed the genomic profile aiming at identifying potential prognostic biomarkers in penile carcinoma. Globally, 46 penile carcinoma samples were considered to evaluate DNA copy-number alterations via array comparative genomic hybridization (aCGH) combined with human papillomavirus (HPV) genotyping. Specific genes were investigated by using qPCR, FISH, and RT-qPCR. Genomic alterations mapped at 3p and 8p were related to worse prognostic features, including advanced T and clinical stage, recurrence and death from the disease. Losses of 3p21.1-p14.3 and gains of 3q25.31-q29 were associated with reduced cancer-specific and disease-free survival. Genomic alterations detected for chromosome 3 (LAMP3, PPARG, TNFSF10 genes) and 8 (DLC1) were evaluated by qPCR. DLC1 and PPARG losses were associated with poor prognosis characteristics. Losses of DLC1 were an independent risk factor for recurrence on multivariate analysis. The gene-expression analysis showed downexpression of DLC1 and PPARG and overexpression of LAMP3 and TNFSF10 genes. Chromosome Y losses and MYC gene (8q24) gains were confirmed by FISH. HPV infection was detected in 34.8% of the samples, and 19 differential genomic regions were obtained related to viral status. At first time, we described recurrent copy-number alterations and its potential prognostic value in penile carcinomas. We also showed a specific genomic profile according to HPV infection, supporting the hypothesis that penile tumors present distinct etiologies according to virus status.
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Affiliation(s)
- Ariane F Busso-Lopes
- CIPE-Cancer Treatment and Research Center, AC Camargo Cancer Center, São Paulo, Brazil
| | - Fábio A Marchi
- CIPE-Cancer Treatment and Research Center, AC Camargo Cancer Center, São Paulo, Brazil
| | - Hellen Kuasne
- CIPE-Cancer Treatment and Research Center, AC Camargo Cancer Center, São Paulo, Brazil. Department of Urology, Faculty of Medicine, UNESP, Botucatu, São Paulo, Brazil
| | | | | | | | - Ademar Lopes
- Department of Pelvic Surgery, AC Camargo Cancer Center, São Paulo, Brazil
| | | | - Silvia R Rogatto
- CIPE-Cancer Treatment and Research Center, AC Camargo Cancer Center, São Paulo, Brazil. Department of Urology, Faculty of Medicine, UNESP, Botucatu, São Paulo, Brazil.
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Barzon L, Cappellesso R, Peta E, Militello V, Sinigaglia A, Fassan M, Simonato F, Guzzardo V, Ventura L, Blandamura S, Gardiman M, Palù G, Fassina A. Profiling of expression of human papillomavirus-related cancer miRNAs in penile squamous cell carcinomas. THE AMERICAN JOURNAL OF PATHOLOGY 2014; 184:3376-83. [PMID: 25455689 DOI: 10.1016/j.ajpath.2014.08.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Revised: 07/18/2014] [Accepted: 08/14/2014] [Indexed: 01/07/2023]
Abstract
Penile squamous cell carcinoma (PSCC) is a rare tumor associated with high-risk human papillomavirus (HR-HPV) infection in 30% to 60% of cases. Altered expression of miRNAs has been reported in HPV-related cervical and head and neck cancers, but such data have not been available for PSCC. We analyzed a series of 59 PSCCs and 8 condylomata for presence of HPV infection, for p16(INK4a), Ki-67, and p53 immunohistochemical expression, and for expression of a panel of cellular miRNAs (let-7c, miR-23b, miR-34a, miR-145, miR-146a, miR-196a, and miR-218) involved in HPV-related cancer. HR-HPV DNA (HPV16 in most cases) was detected in 17/59 (29%) PSCCs; all penile condylomata (8/8) were positive for low-risk HPV6 or HPV11. HR-HPV(+) PSCCs overexpressed p16(INK4a) in 88% cases and p53 in 35% of cases, whereas HR-HPV(-) PSCCs were positive for p16(INK4a) and p53 immunostaining in 9% and 44% of cases, respectively. Among the miRNAs investigated, expression of miR-218 was lower in PSCCs with HR-HPV infection and in p53(-) cancers. Hypermethylation of the promoter of the SLIT2 gene, which contains miR-218-1 in its intronic region, was frequently observed in PSCCs, mainly in those with low miR-218 expression. Epigenetic silencing of miR-218 is a common feature in HR-HPV(+) PSCCs and in HR-HPV(-) PSCCs without immunohistochemical detection of p53.
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Affiliation(s)
- Luisa Barzon
- Department of Molecular Medicine, University of Padua, Padua, Italy
| | | | - Elektra Peta
- Department of Molecular Medicine, University of Padua, Padua, Italy
| | - Valentina Militello
- Department of Molecular Medicine, University of Padua, Padua, Italy; Virology Unit, Parma University Hospital, Parma, Italy
| | - Alessandro Sinigaglia
- Department of Molecular Medicine, University of Padua, Padua, Italy; Veneto Region Oncology Institute (Istituto Oncologico Veneto-IRCCS), Padua, Italy
| | - Matteo Fassan
- Department of Medicine, University of Padua, Padua, Italy
| | | | | | - Laura Ventura
- Department of Statistical Sciences, University of Padua, Padua, Italy
| | | | | | - Giorgio Palù
- Department of Molecular Medicine, University of Padua, Padua, Italy
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Histologic and immunohistochemical assessment of penile carcinomas in a North American population. Am J Surg Pathol 2014; 38:1340-8. [PMID: 25210933 DOI: 10.1097/pas.0000000000000124] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Penile squamous cell carcinoma (SCC) is sometimes an aggressive disease that has a variable worldwide incidence, in part due to differing rates of inflammatory and infectious risk factors. In the developed world, penile SCC is a rare malignancy, and most studies therefore originate in less developed countries. The current study was undertaken to examine the morphologic and immunohistochemical features of penile SCC from a region with low disease incidence. Sixty-two complete or partial penectomy specimens from 59 patients were reviewed. Twenty-six patients had metastasis, 3 had recurrent disease, and 7 were dead due to tumor. Most patients were uncircumcised (72%). Twenty-two percent of carcinomas were associated with lichen sclerosis. Perineural invasion was significantly associated with metastasis (P=0.007). Most SCCs (65%) had the usual keratinizing morphology, and these tumors were significantly associated with the differentiated form of intraepithelial lesion (P<0.0001), p53 positivity (P=0.002), cyclin D1 positivity (P=0.007), and EGFR overexpression (P=0.003). Human papilloma virus (HPV)-associated tumors accounted for 27% and were basaloid (8%), warty (10%), mixed (6%), or lymphoepithelioma-like carcinoma (4%) variants. These were significantly associated with p16 expression (P<0.0001) and the undifferentiated form of intraepithelial lesion (P<0.001). Among all SCCs, there was no difference in the immunohistochemical or in situ hybridization profile between primary tumors and metastases. Although penile SCC is rare in the United States, the tumor variants, immunohistochemical profiles, and proportion of HPV-associated tumors are similar to those in less developed countries. Two distinct pathways appear to lead to carcinogenesis; one is related to underlying chronic inflammatory states, involves p53 mutation, cyclin D1 overexpression, and culminates in classic keratinizing SCC. The other pathway involves high-risk HPV infection, demonstrates strong p16 expression, and results in SCC with varied, but distinctive morphologies.
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Carlson BC, Hofer MD, Ballek N, Yang XJ, Meeks JJ, Gonzalez CM. Protein Markers of Malignant Potential in Penile and Vulvar Lichen Sclerosus. J Urol 2013; 190:399-406. [DOI: 10.1016/j.juro.2013.01.102] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2013] [Indexed: 01/18/2023]
Affiliation(s)
- Bayard C. Carlson
- Departments of Urology and Pathology (XJY), Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Matthias D. Hofer
- Departments of Urology and Pathology (XJY), Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Nathaniel Ballek
- Departments of Urology and Pathology (XJY), Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Ximing J. Yang
- Departments of Urology and Pathology (XJY), Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Joshua J. Meeks
- Departments of Urology and Pathology (XJY), Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Chris M. Gonzalez
- Departments of Urology and Pathology (XJY), Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Do HTT, Koriyama C, Khan NA, Higashi M, Kato T, Le NT, Matsushita S, Kanekura T, Akiba S. The etiologic role of human papillomavirus in penile cancers: a study in Vietnam. Br J Cancer 2013; 108:229-33. [PMID: 23299525 PMCID: PMC3553541 DOI: 10.1038/bjc.2012.583] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background: We investigated the aetiologic role of human papillomavirus (HPV) in 120 penile squamous cell carcinomas (PSCCs) from Vietnam. Methods: Human papillomavirus DNA was detected by PCR using SPF10 primers and a primer set targeting HPV-16 E6. The INNO-LiPA HPV genotyping kit was used to determine genotype. Human papillomavirus-16 viral load and physical status were determined by real-time PCR. P16INK4A protein expression was investigated by immunohistochemistry. Results: Human papillomavirus DNA was detected in 27 of 120 (23%) PSCCs. The most frequently detected genotype was HPV-16 (24 of 27 cases, 89%). In 16 of 18 (89%) HPV-16-positive cases, the HPV DNA was considered to be integrated into the host genome. The geometric mean of the HPV-16 viral load was 0.4 copies per cell. P16INK4A overexpression was significantly related to PSCCs infected with high-risk HPV (P=0.018) and HPV-16 copy numbers (P<0.001). Conclusion: Human papillomavirus-16 DNA integration and p16INK4A overexpression in high-risk HPV detected PSCCs suggested an aetiologic role of high-risk HPV in the development of PSCCs.
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Affiliation(s)
- H T T Do
- Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
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17
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Sonpavde G, Pagliaro LC, Buonerba C, Dorff TB, Lee RJ, Di Lorenzo G. Penile cancer: current therapy and future directions. Ann Oncol 2013; 24:1179-89. [PMID: 23293117 DOI: 10.1093/annonc/mds635] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background Penile cancer (PC) is a rare cancer in western countries, but is more common in parts of the developing world. Due to its rarity and the consequent lack of randomized trials, current therapy is based on retrospective studies and small prospective trials. Design Studies of PC therapy were searched in PubMed and abstracts at major conferences. Results PC is generally an aggressive malignancy characterized by early locoregional lymph node (LN) spread and later metastases in distant sites. Given the strong predictive value of LN involvement for overall survival, evaluating regional LNs is critical. Advanced LN involvement is increasingly being treated with multimodality therapy incorporating chemotherapy and/or radiation. A single superior cisplatin-based regimen has not been defined. Further advances may occur with a better collaboration on an international scale and comprehensive understanding of tumor biology. To this end, the preventive role of circumcision and understanding of the oncogenic roles of Human Papilloma Virus-16, and smoking may yield advances. Preliminary data suggest a role for agents targeting epidermal growth factor receptor and angiogenesis. Conclusion Advances in therapy for PC will require efficient trial designs, synergistic collaboration, incentives to industry and the efforts of patient advocacy groups and venture philanthropists.
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Affiliation(s)
- G Sonpavde
- Department of Medicine, Section of Medical Oncology, UAB Comprehensive Cancer Center, Birmingham
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18
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Ferrándiz-Pulido C, Masferrer E, de Torres I, Lloveras B, Hernandez-Losa J, Mojal S, Salvador C, Morote J, Ramon y Cajal S, Pujol RM, Garcia-Patos V, Toll A. Identification and genotyping of human papillomavirus in a Spanish cohort of penile squamous cell carcinomas: Correlation with pathologic subtypes, p16INK4a expression, and prognosis. J Am Acad Dermatol 2013; 68:73-82. [DOI: 10.1016/j.jaad.2012.05.029] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Revised: 05/10/2012] [Accepted: 05/31/2012] [Indexed: 11/17/2022]
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Abstract
The spectrum of conditions affecting the penile skin is varied and ranges from simple, benign dermatoses to premalignant and malignant conditions. Recently, improved understanding of the aetiology and natural history of these conditions has shaped new treatment paradigms and a functional knowledge of dermatology, urology and genitourinary medicine is required to successfully diagnose and treat these men. In this article, we explore the common precancerous states that can lead to penile carcinoma and review the recent advances with regards to the molecular basis for these dermatoses and the treatments that may be most effective for these men.
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Affiliation(s)
- Oliver Kayes
- Department of Andrology, University College London Hospital, UK.
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20
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Masferrer E, Ferrándiz-Pulido C, Lloveras B, Masferrer-Niubò M, Espinet B, Salido M, Rodríguez-Rivera M, Alemany L, Placer J, Gelabert A, Servitje O, García-Patos V, Pujol RM, Toll A. MYCCopy Number Gains are Associated with Poor Outcome in Penile Squamous Cell Carcinoma. J Urol 2012; 188:1965-71. [DOI: 10.1016/j.juro.2012.07.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Indexed: 11/26/2022]
Affiliation(s)
- Emili Masferrer
- Servei de Dermatologia, Facultat de Medicina, Universitat de Barcelona, Hospital del Mar, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | | | | | - Blanca Espinet
- Laboratori de Citogenètica Mollecular, Servei d′Anatomia Patològica, Barcelona, Spain
| | - Marta Salido
- Laboratori de Citogenètica Mollecular, Servei d′Anatomia Patològica, Barcelona, Spain
| | | | - Laia Alemany
- Programa de Recerca en Epidemiologia del Càncer, Unitat d'Infeccions i Càncer, Institut Català d'Oncologia, Barcelona, Spain
- Institut d'Investigació Biomédica de Bellvitge, Consorcio de Investigación Biomédica de Epidemiologia i Salut Pública, Barcelona, Spain
| | - Jose Placer
- Servei d'Urologia, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | - Octavi Servitje
- Servei de Dermatologia, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Vicenç García-Patos
- Servei de Dermatologia, Facultat de Medicina, Universitat de Barcelona, Hospital del Mar, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - Ramon M. Pujol
- Servei de Dermatologia, Hospital del Mar, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
| | - Agustí Toll
- Servei de Dermatologia, Hospital del Mar, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
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21
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Stankiewicz E, Prowse DM, Ng M, Cuzick J, Mesher D, Hiscock F, Lu YJ, Watkin N, Corbishley C, Lam W, Berney DM. Alternative HER/PTEN/Akt pathway activation in HPV positive and negative penile carcinomas. PLoS One 2011; 6:e17517. [PMID: 21407808 PMCID: PMC3047574 DOI: 10.1371/journal.pone.0017517] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2010] [Accepted: 02/03/2011] [Indexed: 11/26/2022] Open
Abstract
Background The pathogenesis of penile squamous cell carcinoma (PSCC) is not well understood, though risk factors include human papillomavirus (HPV). Disruption of HER/PTEN/Akt pathway is present in many cancers; however there is little information on its function in PSCC. We investigated HER family receptors and phosphatase and tension homolog (PTEN) in HPV-positive and negative PSCC and its impact on Akt activation using immunohistochemistry and fluorescent in situ hybridisation (FISH). Methodology/Principal Findings 148 PSCCs were microarrayed and immunostained for phosphorylated EGFR (pEGFR), HER2, HER3, HER4, phosphorylated Akt (pAkt), Akt1 and PTEN proteins. EGFR and PTEN gene status were also evaluated using FISH. HPV presence was assessed by PCR. pEGFR expression was detected significantly less frequently in HPV-positive than HPV-negative tumours (p = 0.0143). Conversely, HER3 expression was significantly more common in HPV-positive cases (p = 0.0128). HER4, pAkt, Akt and PTEN protein expression were not related to HPV. HER3 (p = 0.0054) and HER4 (p = 0.0002) receptors significantly correlated with cytoplasmic Akt1 immunostaining. All three proteins positively correlated with tumour grade (HER3, p = 0.0029; HER4, p = 0.0118; Akt1, p = 0.0001). pEGFR expression correlated with pAkt but not with tumour grade or stage. There was no EGFR gene amplification. HER2 was not detected. PTEN protein expression was reduced or absent in 62% of tumours but PTEN gene copy loss was present only in 4% of PSCCs. Conclusions/Significance EGFR, HER3 and HER4 but not HER2 are associated with penile carcinogenesis. HPV-negative tumours tend to express significantly more pEGFR than HPV-positive cancers and this expression correlates with pAkt protein, indicating EGFR as an upstream regulator of Akt signalling in PSCC. Conversely, HER3 expression is significantly more common in HPV-positive cases and positively correlates with cytoplasmic Akt1 expression. HER4 and PTEN protein expression are not related to HPV infection. Our results suggest that PSCC patients could benefit from therapies developed to target HER receptors.
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Affiliation(s)
- Elzbieta Stankiewicz
- Centre for Molecular Oncology and Imaging, Institute of Cancer, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.
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