Perceau G, Derancourt C, Clavel C, Durlach A, Pluot M, Lardennois B, Bernard P
Department of Dermatology, Centre Hospitalier Universitaire Robert-Debré, Avenue du Maréchal Koenig, F-51092 Reims cedex, France.
Br J Dermatol. 2003 May;148(5):934-8. doi: 10.1046/j.1365-2133.2003.05326.x.
Penile squamous cell carcinoma (SCC) may occur on pre-existing lesions of lichen sclerosus (LS). However, the prevalence of histological changes of LS in penile SCC is not well established. Moreover, mucosal oncogenic human papillomaviruses (HPVs) are sometimes detected in penile SCC, but have not been systematically sought in LS-associated penile SCC.
To establish the prevalence of LS histological changes and of mucosal oncogenic HPV in a series of patients with penile SCC.
Consecutive cases of histologically proven penile SCC from a single university hospital over a 14-year period were retrospectively selected and reviewed. Histological signs of LS were systematically sought. HPV was detected by polymerase chain reaction (PCR) amplification of DNA from paraffin-embedded skin samples using general primers GP5+/GP6+ (allowing detection of mucosal HPV) and oncogenic type 16-, 18-, 31- and 33-specific primers.
Eighteen cases of penile SCC were found. The mean +/- SD age of patients at diagnosis was 67.3 (14.5 years). In eight of 18 (44%) cases, SCC was associated with histological features of LS. Seventeen skin biopsy specimens of SCC (nine without and eight with LS histology) were subjected to PCR amplification for HPV. Mucosal HPV was detected in six of them (35%). Five of nine SCCs without histological features of LS were positive for mucosal HPV: three with HPV type 16 and two with only general primers. In contrast, all eight SCCs associated with LS were negative for oncogenic HPV types, although one was positive with general primers.
Penile SCC seems to be frequently associated with LS histological changes. As with vulval SCC, we found that non-LS-associated penile SCC tended to be frequently associated with oncogenic HPV infection, whereas LS-associated penile SCC was not. Larger series are needed to confirm this association.
阴茎鳞状细胞癌（SCC）可能发生于先前存在的硬化性苔藓（LS）病变之上。然而，阴茎SCC中LS组织学改变的发生率尚未完全明确。此外，有时在阴茎SCC中可检测到黏膜致癌性人乳头瘤病毒（HPV），但在与LS相关的阴茎SCC中尚未进行系统筛查。
确定一系列阴茎SCC患者中LS组织学改变及黏膜致癌性HPV的发生率。
回顾性选取并分析了一所大学医院14年间经组织学证实的阴茎SCC连续病例。系统查找LS的组织学特征。采用通用引物GP5+/GP6+（用于检测黏膜HPV）以及致癌性16、18、31和33型特异性引物，通过聚合酶链反应（PCR）扩增石蜡包埋皮肤样本中的DNA来检测HPV。
共发现18例阴茎SCC。患者诊断时的平均年龄±标准差为67.3（14.5岁）。18例中有8例（44%）SCC与LS的组织学特征相关。对17例SCC皮肤活检标本（9例无LS组织学特征，8例有）进行HPV的PCR扩增。其中6例（35%）检测到黏膜HPV。9例无LS组织学特征的SCC中有5例黏膜HPV呈阳性：3例为16型HPV，2例仅通用引物呈阳性。相比之下，所有8例与LS相关的SCC致癌性HPV型均为阴性，尽管1例通用引物呈阳性。
阴茎SCC似乎常与LS组织学改变相关。与外阴SCC一样，我们发现非LS相关的阴茎SCC往往常与致癌性HPV感染相关，而LS相关的阴茎SCC则不然。需要更大规模的研究系列来证实这种关联。
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