Clinical and epidemologic relevance of HPV in Penile Cancer: a retrospective study

• Type: Thesis
• Date: 2023-05-29

Authors

Ana Rita Macieira Marques (Author) FMUP

Thesis

Clinical and epidemologic relevance of HPV in Penile Cancer: a retrospective study

Master's Degree

Dissertation

Scientific classification

FOS: Medical and Health sciences > Clinical medicine

Associated Institutions

fmup

Other information

DOI: 10.34626/wqw2-zp35

Resumo (PT): Background: A incidência de cancro do pénis está a aumentar na maioria dos países europeus. Vários fatores de risco foram identificados, nomeadamente a infeção pelo papilomavírus humano (HPV). No entanto, o papel exato do HPV na carcinogénese do cancro de pénis ainda é desconhecido. Esclarecer a contribuição do HPV no cancro do pénis é crucial, pois pode melhorar as estratégias de prevenção e tratamento. Objetivos: O objetivo deste estudo é descrever as características dos pacientes com cancro do pénis e neoplasia intraepitelial peniana (PeIN), avaliar a prevalência de HPV-DNA no tecido tumoral e identificar diferenças entre pacientes com e sem HPV-DNA. Métodos: Foi realizado um estudo observacional retrospectivo incluindo pacientes com diagnóstico histológico de carcinoma espinocelular (CEC) peniano ou PeIN entre 2012 e 2021 de um hospital universitário. A análise do HPV foi realizada usando CLART Papillomavirus, para a deteção e tipagem de 28 tipos de HPV em amostras de tecido. Resultados: Um total de 25 pacientes foram incluídos. A maioria dos tumores identificados foram CEC invasivo (n=11) e CEC in situ (PeIN 3) (n= 8). O DNA-HPV foi testado em todas as amostras de tecido e foi detectado em 18 delas. DNA de HPV de alto risco foi identificado em todas as amostras de HPV positivas, exceto uma. Os tipos de HPV incluídos na vacina nonavalente contra o HPV foram identificados em 16 das 18 amostras positivas para HPV-DNA. Estratificando os pacientes de acordo com a deteção de HPV-DNA, descobrimos que os pacientes com HPV-DNA eram mais jovens (57,5 anos vs. 70 anos, p=0,047), menos propensos a ter fimose (5,8% vs. 42,9%, p=0,022) e tinham mais lesões PeIN do que CEC invasivo (85,7% vs. 27,8%, p=0,025). Conclusão: Este estudo mostra uma prevalência de HPV-DNA em CEC peniano e lesões pré-malignas de 45,5% e 92,9%, respetivamente. Identificar o envolvimento do HPV na patologia CEC e PeIN tem o potencial de orientar o tratamento e melhorar as estratégias de follow-up. A avaliação do impacto da vacina contra o HPV no cancro do pénis está ainda em andamento.

Abstract (EN): Background: Penile cancer is rising in most European countries. Several risk factors have been identified, namely human papillomavirus (HPV) infection. However, the exact role of HPV in penile cancer carcinogenesis is still unknown. Clarifying the contribution of HPV in penile cancer is crucial as it may improve prevention and treatment strategies. Objectives: The aim of this study is to describe the characteristics of patients with penile cancer and penile intraepithelial neoplasia (PeIN), evaluate the prevalence of HPV-DNA in tumor tissue, and identify differences between patients with and without HPV-DNA. Methods: A retrospective observational study including patients with histological diagnosis of penile squamous cell carcinoma (SCC) or PeIN between 2012 and 2021 in a university hospital was carried out. HPV analysis was performed using CLART Papillomavirus, for the detection and typing of 28 types of HPV in tissue specimens. Results: A total of 25 patients were included. Most of the tumors identified were invasive SCC (n=11) and SCC in situ (PeIN 3) (n= 8). HPV-DNA was tested in all tissue specimens and was detected in 18 of them. High risk HPV DNA was identified in all positive HPV samples, except one. HPV types included in the nonavalent HPV vaccine were identified in 16 of the 18 samples positive for HPV-DNA. Stratifying patients according to HPV-DNA detection, we found that patients with HPV-DNA were younger (57.5 years vs. 70 years, p=0.047), less likely to have phimosis (5.8% vs. 42.9%, p=0.022) and more likely to have PeIN lesions than invasive SCC (85.7% vs. 27.8%, p=0.025 ). Conclusion: This study shows a prevalence of HPV-DNA in penile SCC and premalignant lesions of 45.5% and 92.9%, respectively. Identifying HPV involvement in SCC and PeIN pathology has the potential to guide treatment and enhance follow-up strategies. The neutral-gender HPV vaccine impact assessment on penile cancer in ongoing.

Language: English

No. of pages: 54