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Santos RDS, Hirth CG, Pinheiro DP, Bezerra MJB, Silva-Fernandes IJDL, Paula DSD, Alves APNN, Moraes Filho MOD, Moura ADAA, Lima MVA, Pessoa CDÓ, Furtado CLM. HPV infection and 5mC/5hmC epigenetic markers in penile squamous cell carcinoma: new insights into prognostics. Clin Epigenetics 2022; 14:133. [PMID: 36284309 PMCID: PMC9597985 DOI: 10.1186/s13148-022-01360-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/09/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Penile cancer is one of the most aggressive male tumors. Although it is preventable, the main etiologic causes are lifestyle behaviors and viral infection, such as human papillomavirus (HPV). Long-term epigenetic changes due to environmental factors change cell fate and promote carcinogenesis, being an important marker of prognosis. We evaluated epidemiological aspects of penile squamous cell carcinoma (SCC) and the prevalence of HPV infection using high-risk HPV (hrHPV) and p16INK4A expression of 224 participants. Global DNA methylation was evaluated through 5-methylcytosine (5mC) and 5-hydroxymethylcytosine (5hmC). RESULTS The incidence of HPV was 53.2% for hrHPV and 22.32% for p16INK4a. hrHPV was not related to systemic or lymph node metastasis and locoregional recurrence, nor influenced the survival rate. P16INK4a seems to be a protective factor for death, which does not affect metastasis or tumor recurrence. Lymph node and systemic metastases and locoregional recurrence increase the risk of death. An increased 5mC mark was observed in penile SCC regardless of HPV infection. However, there is a reduction of the 5hmC mark for p16INK4a + (P = 0.024). Increased 5mC/5hmC ratio (> 1) was observed in 94.2% of penile SCC, irrespective of HPV infection. Despite the increase in 5mC, it seems not to affect the survival rate (HR = 1.06; 95% CI 0.33-3.38). CONCLUSIONS P16INK4a seems to be a good prognosis marker for penile SCC and the increase in 5mC, an epigenetic mark of genomic stability, may support tumor progression leading to poor prognosis.
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Affiliation(s)
- Renan da Silva Santos
- grid.8395.70000 0001 2160 0329Drug Research and Development Center, Department of Physiology and Pharmacology, Federal University of Ceará, Fortaleza, Brazil
| | | | - Daniel Pascoalino Pinheiro
- grid.8395.70000 0001 2160 0329Drug Research and Development Center, Department of Physiology and Pharmacology, Federal University of Ceará, Fortaleza, Brazil
| | | | | | - Dayrine Silveira de Paula
- grid.8395.70000 0001 2160 0329Department of Dental Clinic, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil
| | - Ana Paula Negreiros Nunes Alves
- grid.8395.70000 0001 2160 0329Drug Research and Development Center, Postgraduate Program in Translational Medicine, Federal University of Ceará, Fortaleza, Brazil ,grid.8395.70000 0001 2160 0329Department of Dental Clinic, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Brazil
| | - Manoel Odorico de Moraes Filho
- grid.8395.70000 0001 2160 0329Drug Research and Development Center, Department of Physiology and Pharmacology, Federal University of Ceará, Fortaleza, Brazil ,grid.8395.70000 0001 2160 0329Drug Research and Development Center, Postgraduate Program in Translational Medicine, Federal University of Ceará, Fortaleza, Brazil
| | | | - Marcos Venício Alves Lima
- Laboratory of Pathology, Cancer Institute of Ceará, Fortaleza, Brazil ,Laboratory of Molecular Biology and Genetics, Cancer Institute of Ceará, Fortaleza, Brazil
| | - Claudia do Ó Pessoa
- grid.8395.70000 0001 2160 0329Drug Research and Development Center, Department of Physiology and Pharmacology, Federal University of Ceará, Fortaleza, Brazil
| | - Cristiana Libardi Miranda Furtado
- grid.8395.70000 0001 2160 0329Drug Research and Development Center, Postgraduate Program in Translational Medicine, Federal University of Ceará, Fortaleza, Brazil ,grid.412275.70000 0004 4687 5259Experimental Biology Center, University of Fortaleza, Fortaleza, Brazil
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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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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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Barrios MC, Rodríguez LS, Pachón CM, Lugo EA. Educational Intervention on Human Papillomavirus in University Students. Indian J Community Med 2019; 44:213-216. [PMID: 31602105 PMCID: PMC6776946 DOI: 10.4103/ijcm.ijcm_247_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 06/11/2019] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION In recent years, there has been an increase in the number of cases of women and men suffering from a sexually transmitted disease. OBJECTIVE The objective of this study was to implement an educational intervention on the human papillomavirus (HPV) to increase knowledge about the disease among university students. MATERIALS AND METHODS In a preexperimental study with 385 students of both genders, the strategy was designed under the parameters of the PAHO and the Theory of Beliefs in Health. The problem was identified through biological samples of the genitals, and the impact was measured through a questionnaire. The presence of HPV DNA was made with molecular polymerase chain reaction tests; and the answers, through coefficients of variation. RESULTS Of the participants, 60 were positive: 49 women and 11 men. At the beginning of the application, the knowledge level was medium, between 9.0 and 9.6. After the application, it was between 12.5 and 13, being the level of knowledge average, but very close to the threshold of high. CONCLUSIONS With the results of the tests, it was found that HPV is a real problem among university students. The level of knowledge remained medium, despite the educational intervention.
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Affiliation(s)
- Meryene C. Barrios
- Department of Health Sciencies, Faculty of Health Sciences, Corposucre, Sincelejo, Sucre, Colombia
| | - Liliana Stella Rodríguez
- Department of Health Sciencies, Faculty of Health Sciences, Corposucre, Sincelejo, Sucre, Colombia
| | - Claudia M. Pachón
- Department of Health Sciencies, Faculty of Health Sciences, Corposucre, Sincelejo, Sucre, Colombia
| | - Emily A. Lugo
- Department of Administrative Economic and Accounting Sciencies, Faculty of Economic, Administrative and Accounting Sciences, Corposucre, Sincelejo, Sucre, Colombia
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Mao W, Zhang Z, Huang X, Fan J, Geng J. Marital Status and Survival in Patients with Penile Cancer. J Cancer 2019; 10:2661-2669. [PMID: 31258774 PMCID: PMC6584924 DOI: 10.7150/jca.32037] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 04/27/2019] [Indexed: 01/06/2023] Open
Abstract
Purpose: We aimed to reveal the effects of marital status on survival outcomes in patients with penile cancer. Methods: Patients with penile cancer who were diagnosed between 2004 and 2015 were identified by using the Surveillance, Epidemiology and End Results (SEER) database. Kaplan-Meier and Cox regressions were used to analyse the effects of marital status on overall survival (OS) and cancer-specific survival (CSS). Results: Among 3,195 eligible patients with penile cancer, 1,951 (61.1%) patients were married, 365 (11.4%) were divorced or separated, 327 (10.2%) were widowed and 552 (17.3%) were single. The widowed patients had the worst OS median survival time (22 months) and CSS median survival time (23.5 months). Marital status was an independent prognostic factor for OS and CSS of penile cancer patients. The multivariate Cox regression showed that widowed patients exhibited the poorest OS (hazard ratio [HR]: 1.73; 95% confidence interval [CI]: 1.48-2.03, p < 0.001) and the poorest CSS (HR: 1.64; 95% CI: 1.144-1.279, p < 0.001) compared with married patients. Similar results were observed in our centre database and the subgroup analyses based on the SEER stage and grade. Conclusions: In our study, we found that marital status was an independent prognostic factor for survival in patients with penile cancer. Additionally, widowed patients had the lowest OS and CSS compared with married patients.
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Affiliation(s)
- Weipu Mao
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200072, China
| | - Ziwei Zhang
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200072, China
| | - Xin Huang
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200072, China
| | - Jie Fan
- Department of Pathology, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Jiang Geng
- Department of Urology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200072, China
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