Instituto de Patología e Investigación, Asunción, Paraguay.
World J Urol. 2013 Aug;31(4):861-7. doi: 10.1007/s00345-011-0802-0. Epub 2011 Nov 25.
The incidence of penile cancer is four times higher in Paraguay than in the United States or Europe. There are no adequate scientific explanations for this geographical variation. The goal of this study was to evaluate the interplay among risk factors, morphology of the primary tumor, and HPV status.
Information on socioeconomic status, education level, habits, and sexual history was obtained in 103 Paraguayan patients with penile cancer. All patients were then treated by surgery, and specimens were evaluated histopathologically.
Patients usually dwelled in rural/suburban areas (82%), lived in poverty (75%), had a low education level (91%), and were heavy smokers (76%). Phimosis (57%), moderate/poor hygienic habits (90%), and history of sexually transmitted diseases (74%) were frequently found. Patients with >10 lifetime female partners had an odds ratio of 3.8 (95% CI 1.1, 12.6; P-trend = .03) for presenting HPV-positive tumors when compared to patients with <6 partners. However, this trend was not significant when the number of sexual partners was adjusted for age of first coitus and antecedents of sexually transmitted diseases. HPV-related tumors (found in 36% of the samples) were characterized by a warty and/or basaloid morphology and high histological grade in most cases.
In our series, patients with penile cancer presented a distinctive epidemiologic and pathologic profile. These data might help explaining the geographical differences in incidence and aid in the design of strategies for cancer control in Paraguay.
巴拉圭的阴茎癌发病率比美国和欧洲高四倍。对于这种地理差异，目前还没有充分的科学解释。本研究的目的是评估风险因素、原发性肿瘤形态和 HPV 状态之间的相互作用。
我们对 103 例巴拉圭阴茎癌患者的社会经济状况、教育水平、习惯和性史信息进行了评估。所有患者均接受手术治疗，并进行组织病理学评估。
患者通常居住在农村/郊区（82%），生活贫困（75%），教育水平低（91%），吸烟量大（76%）。包茎（57%）、卫生习惯中等/差（90%）和性传播疾病史（74%）较为常见。与性伴侣少于 6 人的患者相比，性伴侣超过 10 人的患者 HPV 阳性肿瘤的比值比为 3.8（95%CI 1.1, 12.6；P 趋势=.03）。然而，当将首次性交年龄和性传播疾病史的情况调整到性伴侣数量时，这种趋势并不显著。HPV 相关肿瘤（在 36%的样本中发现）的形态学特征通常为疣状和/或基底样，并在大多数情况下具有高组织学分级。
在我们的研究中，阴茎癌患者表现出独特的流行病学和病理学特征。这些数据可能有助于解释发病率的地理差异，并有助于制定巴拉圭癌症控制策略。
