Lam K Y, Chan K W
Department of Pathology, The University of Hong Kong, Hong Kong.
Arch Pathol Lab Med. 1999 Oct;123(10):895-904. doi: 10.5858/1999-123-0895-MPACFO.
To examine the histologic features of p21 in penile tumors and to determine the role of p21 and p53 in the pathogenesis of this group of tumors.
The clinicopathologic features of 87 patients with penile tumors were studied. The expression of p53 and p21 proteins in 49 cases was investigated by immunohistochemistry.
Of the 87 tumors studied, 84 represented primary penile tumors (72 malignant and 12 benign) and 3 represented secondary tumors (2 from bladder, 1 from nasopharynx). The primary malignant penile tumors included 66 surface carcinomas with squamous differentiation (92%), 3 cases of Paget disease (4%), 1 case of Bowen disease (1%), and 2 penile urethral squamous cell carcinomas (3%). The former group was subdivided into squamous cell carcinoma (n = 50), verrucous carcinoma (n = 8), basaloid squamous cell carcinoma (n = 3), adenoid squamous cell carcinoma (n = 3), spindle cell carcinoma (n = 1), and adenosquamous carcinoma (n = 1). The benign tumors were squamous cell papillomas (n = 10) and fibromatoses (n = 2). Expression of p21 and p53 was noted in 40% and 89%, respectively, of the 47 patients with primary surface penile carcinoma with squamous differentiation. Positive p21 and p53 expression was also seen in 2 cases of Paget disease. Staining for p21 was often weak and was found in the suprabasal region of carcinomas with squamous differentiation, while p53 expression was seen in the basal region of squamous cell carcinomas. Preinvasive lesions also showed p21 and p53 expression. An inverse correlation between p53 and p21 expression (p53(+)/p21(-) or p53(-)/p21(+)) was noted in half of the squamous cell carcinomas, 4 of 5 verrucous carcinomas, 2 of 3 basaloid squamous cell carcinomas, and in 1 spindle cell carcinoma. The other cases did not show this correlation.
Penile tumors had different histologic variants and p21/p53 expression patterns. Expression of p21 did play a role in some tumors and could be dependent or independent of p53 expression.
研究p21在阴茎肿瘤中的组织学特征，并确定p21和p53在这组肿瘤发病机制中的作用。
对87例阴茎肿瘤患者的临床病理特征进行研究。采用免疫组织化学方法检测49例患者中p53和p21蛋白的表达。
在研究的87例肿瘤中，84例为原发性阴茎肿瘤（72例恶性，12例良性），3例为继发性肿瘤（2例来自膀胱，1例来自鼻咽）。原发性恶性阴茎肿瘤包括66例具有鳞状分化的表面癌（92%）、3例佩吉特病（4%）、1例鲍温病（1%）和2例阴茎尿道鳞状细胞癌（3%）。前一组又细分为鳞状细胞癌（n = 50）、疣状癌（n = 8）、基底样鳞状细胞癌（n = 3）、腺样鳞状细胞癌（n = 3）、梭形细胞癌（n = 1）和腺鳞癌（n = 1）。良性肿瘤为鳞状细胞乳头状瘤（n = 10）和纤维瘤病（n = 2）。在47例具有鳞状分化的原发性阴茎表面癌患者中，分别有40%和89%的患者检测到p21和p53的表达。在2例佩吉特病患者中也观察到p21和p53的阳性表达。p21染色通常较弱，见于具有鳞状分化的癌的基底上层区域，而p53表达见于鳞状细胞癌的基底区域。癌前病变也显示p21和p53表达。在一半的鳞状细胞癌、5例疣状癌中的4例、3例基底样鳞状细胞癌中的2例以及1例梭形细胞癌中，观察到p53和p21表达呈负相关（p53(+)/p21(-)或p53(-)/p21(+)）。其他病例未显示这种相关性。
阴茎肿瘤具有不同的组织学变异和p21/p53表达模式。p21的表达在某些肿瘤中确实起作用，可能依赖或不依赖于p53的表达。
