Radboud University Nijmegen, Medical Centre, Dept. of Urology, Geert Grooteplein Zuid 10 - Internal Route 659, 6525 GA Nijmegen, The Netherlands.
Vaccine. 2012 Oct 12;30(46):6573-7. doi: 10.1016/j.vaccine.2012.08.034. Epub 2012 Aug 30.
The prevalence of penile cancer varies between 1.5 (industrialized countries) and 4.5 per 100,000 men (non-industrialized countries). Predominant histological subtype is squamous cell carcinoma (SCC). Human papillomavirus (HPV) is found in 40-46% of cases: penile cancer is considered to behave as vulvar cancer. Non HPV related risk factors are lack of circumcision, phimosis, chronic inflammation, and smoking. The role of lichen sclerosus (LS) is unclear. Clinical diagnosis is difficult and treatment often mutilating. Preventive measures can be taken since the risk factors are known: the use of the prophylactic HPV vaccines may contribute. We measured the prevalence of HPV and LS in penile cancer in Belgium.
We found 76 samples of penile lesions in the archives of the departments of Histology of four university hospitals in Belgium. Real-time PCR of type-specific HPV DNA was performed targeting 18 HPV types.
Patients with penile intraepithelial neoplasia (PeIN) were 56.1 years of age: patients with invasive penile cancer (IPC) 68.5 (p=0.009). Fifty-five samples (55/76) were adequate for HPV targeting. Overall HPV DNA was 70.9%: 89.5% in samples of PeIN (n=19) and 61.1% in samples of IPC (n=36). Invasive penile cancer samples were less likely to be HPV infected (p=0.028). HPV 16 was most prevalent: 48.3%: 20% PeIN, and 28.3% IPC. HPV DNA of the types, included in the prophylactic vaccines, was found in 33% of PeIN and 31.7% of IPC samples. Thrice, low risk HPV (lrHPV) types 6 (1 IPC) and 11 (1 PeIN, 1 IPC) were solely present. There was no difference in the presence of LS between HPV positive and HPV negative samples (p=0.944).
Prevalence of HPV DNA in penile lesions in Belgium is high. However, the prophylactic vaccines may contribute to primary prevention of only a subset of cases. The role of LS remains unclear.
阴茎癌的发病率在 1.5 例（工业化国家）至 4.5 例/10 万男性（非工业化国家）之间有所不同。主要组织学亚型为鳞状细胞癌（SCC）。40-46%的病例中可发现人乳头瘤病毒（HPV）：阴茎癌被认为与外阴癌的行为相似。非 HPV 相关的危险因素包括未行包皮环切术、包茎、慢性炎症和吸烟。扁平苔藓（LS）的作用尚不清楚。临床诊断困难，治疗常致残。由于已知危险因素，可采取预防措施：预防性 HPV 疫苗的使用可能会有所帮助。我们在比利时测量了阴茎癌中 HPV 和 LS 的流行率。
我们在比利时四所大学医院的组织学部门的档案中找到了 76 例阴茎病变样本。对 18 种 HPV 类型进行了针对特定 HPV 类型的实时 PCR。
患有阴茎上皮内瘤变（PeIN）的患者年龄为 56.1 岁：患有浸润性阴茎癌（IPC）的患者为 68.5 岁（p=0.009）。55 例（55/76）样本适合 HPV 靶向检测。总体 HPV DNA 阳性率为 70.9%：PeIN 样本中为 89.5%（n=19），IPC 样本中为 61.1%（n=36）。HPV 感染的 IPC 样本更有可能呈阴性（p=0.028）。HPV 16 最为常见：48.3%：20% PeIN 和 28.3% IPC。预防性疫苗中包含的 HPV 类型 DNA 见于 33%的 PeIN 和 31.7%的 IPC 样本中。低危型 HPV（lrHPV）6 型（1 例 IPC）和 11 型（1 例 PeIN，1 例 IPC）仅单独存在 3 次。HPV 阳性和 HPV 阴性样本中 LS 的存在无差异（p=0.944）。
比利时阴茎病变中 HPV DNA 的流行率很高。然而，预防性疫苗可能仅对部分病例起到初级预防作用。LS 的作用仍不清楚。
