Instituto de Patología e Investigación, Asunción, Paraguay.
Am J Surg Pathol. 2010 Jan;34(1):104-14. doi: 10.1097/PAS.0b013e3181c76a49.
Human papillomavirus (HPV) has been reported in 12-82% of penile squamous cell carcinomas (SCC). There is an association of the virus with basaloid and warty carcinomas but the reported prevalence is variable. The causes of these variations are not clear. They may be owing to geographic differences, the use of different techniques to detect HPV, the status of the original paraffin blocks, or to variable criteria in tumor classification. The aims of the study were to determine the prevalence of HPV in penile SCC and subtypes using a sensitive technique, to investigate genotypes involved, and to search for other morphologic features associated with the virus from a series of cases from Paraguay. HPV detection was done by SPF-10 polymerase chain reaction followed by DNA enzyme-immunoassay and genotyping by LIPA 25 (version 1). Samples were tested at Catalan Institute of Oncology, Barcelona, and cross testing was carried out at the Delft Diagnostic Laboratories in The Netherlands. HPV was detected in 64 of 202 cases (32%). Thirteen tumors had multiple HPV genotypes. Most prevalent genotypes were HPV-16 (46 cases), HPV-6 (6 cases), and HPV-18 (4 cases), either in single or in multiple infections. HPV was preferentially associated with warty-basaloid (82%), basaloid (76%), and warty (39%) carcinomas and not detected in verrucous, mixed verrucous-papillary, pseudohyperplastic, and pseudoglandular SCCs. There was a strong association between HPV and higher histologic grade. Basaloid cells were more frequently found in HPV positive tumors (72%) and this association was statistically significant in univariate and multivariate analyses. Cells with koilocytotic features and keratinizing squamous cells were also present but to a much lesser degree (47% and 19%, respectively). In summary, HPV was found in a third of the cases and the most common genotype was HPV-16. Low-risk genotypes were rarely found in single infections, representing 4 cases among all analyzed (2%). There was an association between HPV presence and higher histologic grade and with basaloid, warty-basaloid, and warty carcinomas. Our results also suggest that, in penile SCC, the basaloid cell is the best tissue marker for oncogenic HPV infection.
人乳头瘤病毒（HPV）已在 12-82%的阴茎鳞状细胞癌（SCC）中报道。该病毒与基底细胞样和疣状癌有关，但报道的流行率各不相同。这些差异的原因尚不清楚。它们可能是由于地理位置的差异，使用不同的技术来检测 HPV，原始石蜡块的状态，或肿瘤分类标准的差异。该研究的目的是使用敏感技术确定阴茎 SCC 和亚型中 HPV 的流行率，研究涉及的基因型，并从巴拉圭的一系列病例中寻找与病毒相关的其他形态特征。HPV 的检测是通过 SPF-10 聚合酶链反应（PCR），然后进行 DNA 酶免疫测定，以及 LIPA 25（版本 1）进行基因分型。样品在巴塞罗那的加泰罗尼亚肿瘤研究所进行测试，在荷兰的代尔夫特诊断实验室进行交叉测试。在 202 例病例中，HPV 检测到 64 例（32%）。13 例肿瘤存在多种 HPV 基因型。最常见的基因型是 HPV-16（46 例）、HPV-6（6 例）和 HPV-18（4 例），无论是单一感染还是多重感染。HPV 主要与疣状基底细胞样（82%）、基底细胞样（76%）和疣状（39%）癌相关，而在疣状、混合疣状-乳头状、假增生性和假腺性 SCC 中未检测到。HPV 与较高的组织学分级有很强的相关性。在 HPV 阳性肿瘤中，基底细胞样细胞更常见（72%），在单变量和多变量分析中，这种相关性具有统计学意义。也存在空泡细胞特征和角化鳞状细胞，但程度要低得多（分别为 47%和 19%）。总之，HPV 在三分之一的病例中发现，最常见的基因型是 HPV-16。低危基因型在单一感染中很少见，在所有分析的病例中占 4 例（2%）。HPV 的存在与较高的组织学分级以及基底细胞样、疣状基底细胞样和疣状癌有关。我们的结果还表明，在阴茎 SCC 中，基底细胞样细胞是 HPV 致癌感染的最佳组织标志物。
