Distribution of Human Papilloma Virus Genotypes and Dermatoses in Penile Carcinoma in a Low Incidence Area in Europe.
Sebastian Mannweiler, Stephan Sygulla, Elke Winter, Yas Razmara, Karl Pummer, Sigrid Regauer. Medical University Graz, Austria
Background: Invasive penile squamous cell carcinoma (SCC) accounts for 0.4-0.6% of all male malignancies in the USA and Europe. Investigations on the presence of transforming HPV-infections, LS and LP in a low incidence area for penile SCC in a homogenous patient cohort are rare.
Design: The distribution of human papillomavirus virus (HPV), lichen sclerosus (LS) and lichen planus (LP) in archival formalin-fixed specimens of 30 basaloid high-grade penile intraepithelial neoplasia (PeIN) and 108 invasive penile SCC was analysed for 28 HPV-LR and HPV-HR-genotypes(Inno-Lipa HPV Genotyping Extra) and immunohistochemically for over-expression of p16, a “surrogate” marker for transforming HPV-infection.
Results: Of 30 PeIN with p16 overexpression, 23/30 PeIN revealed a single HPV-genotype: HPV-HR16 (22) and HPV-HR18 (1). 1 PeIN each with type-specific reaction products for HPV-HR 16, 18, 33 and 73 revealed additional reaction products indicating a possible co-infection. 2 PeIN revealed multiple type-specific HPV-HR genotypes including HPV-HR18, only 1 PeIN revealed multiple HPV-HR genotypes without HPV16/18. In 60 SCC with p16-overexpression, HPV-HR 16 was the single genotype in 42/53 pT1, 4/5pT2 and 2/2 pT3 SCC, HPV-HR 45 the single genotype in 1 SCC. HPV-HR18 was not detected as single genotype. 5/60 SCC revealed type-specific HPV-HR 33 with possible co-infection with HPV-HR 52 and HPV-LR 54. 2/60 SCC contained multiple HPV genotypes in addition to HPV-HR16. 4/60 SCC harboured multiple type-specific HPV-HR genotypes without HPV-HR16/18. Overall, a single HPV-genotype was identified in 80% HPV-induced penile lesions: HPV-HR16 (22 PeIN, 48 SCC), HPV-HR45 (1 SCC) and HPV-HR18 (1 PeIN). 7 SCC & 2 PeIN with type-specific product for HPV-HR 33, HPV-HR 16, HPV-HR 18 and HPV-HR 73 revealed additional reaction products suggestive of co-infection. 14/90 lesions (15%) showed multiple type-specific HPV-HR-genotypes: 4% with & 11% without HPV-HR16/18. 20/90 PeIN/SCC (22%) harboured type-specific HPV-HR-genotypes other than HPV-HR16/18. 46/48 p-16-negative SCC were HPV negative and associated with LS > LP in more than 50%. The two p16-neg. SCC were a HPV-LR6-positive condylomatous SCC and a HPV-HR45-positive SCC.
Conclusions: 60% of invasive SCC and all PeIN were HPV-induced, with HPV 16 being the sole genotype in 80%. HPV18 & other HR-genotypes were identified in 20%. 40% of invasive SCC were HPV-negative. LS was the predominant dermatosis in non-HPV-associated penile cancer. These cancers may be prevented by early recognition and appropriate treatment.
Category: Genitourinary (including renal tumors)
Tuesday, March 1, 2011 1:00 PM
Poster Session IV # 90, Tuesday Afternoon