Department of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Centre for Gynaecologic Oncology Amsterdam, Department of Obstetrics and Gynaecology, VU University Medical Center, Amsterdam, The Netherlands.
J Urol. 2015 Feb;193(2):526-31. doi: 10.1016/j.juro.2014.08.087. Epub 2014 Aug 21.
The incidence of penile cancer is increasing, and is suggested to be explained by changes in sexual practice and increased exposure of men to sexually transmitted high risk human papillomavirus infection. In penile cancers from a Dutch population treated in 1963 to 2001 we found a high risk human papillomavirus prevalence of about 30%. In this study we assessed the prevalence of high risk human papillomavirus-DNA in a more recent, contemporary penile cancer cohort and its association with patient survival.
High risk human papillomavirus-DNA presence was assessed by GP5+6+ polymerase chain reaction in 212 formalin fixed, paraffin embedded invasive penile tumor specimens of patients treated between 2001 and 2009. The 5-year disease specific survival was calculated using the Kaplan-Meier method with the log rank test and Cox regression.
High risk human papillomavirus-DNA was detected in a subset of penile cancer cases (25%, 95% CI 19-31). HPV16 was the predominant type, representing 79% (42 of 53) of all high risk human papillomavirus infections. The 5-year disease specific survival in the high risk human papillomavirus negative group and the high risk human papillomavirus positive group was 82% and 96%, respectively (log rank test p=0.016). Adjusted for stage, grade, lymphovascular invasion and age, human papillomavirus status was still prognostic for disease specific survival (p=0.030) with a hazard ratio of 0.2 (95% CI 0.1-0.9).
High risk human papillomavirus-DNA was observed in a quarter of penile cancer cases. No relevant increase in high risk human papillomavirus prevalence in recent decades was observed. The presence of high risk human papillomavirus-DNA in penile cancer confers a survival advantage.
阴茎癌的发病率正在上升，据推测这与性行为方式的改变以及男性接触高风险人乳头瘤病毒感染的机会增加有关。在 1963 年至 2001 年期间接受治疗的荷兰人群中的阴茎癌中，我们发现大约 30%的病例存在高危型人乳头瘤病毒。在这项研究中，我们评估了近期、当代阴茎癌队列中高危型人乳头瘤病毒-DNA 的流行情况及其与患者生存的关系。
通过 GP5+6+聚合酶链反应，评估 212 例福尔马林固定、石蜡包埋的浸润性阴茎肿瘤标本中高危型人乳头瘤病毒-DNA 的存在情况，这些患者均在 2001 年至 2009 年期间接受治疗。采用 Kaplan-Meier 方法计算 5 年疾病特异性生存率，并用对数秩检验和 Cox 回归进行分析。
高危型人乳头瘤病毒-DNA 存在于部分阴茎癌病例中（25%，95%CI 19-31）。HPV16 是主要类型，占所有高危型人乳头瘤病毒感染的 79%（42/53）。高危型人乳头瘤病毒阴性组和高危型人乳头瘤病毒阳性组的 5 年疾病特异性生存率分别为 82%和 96%（对数秩检验，p=0.016）。调整分期、分级、脉管侵犯和年龄后，人乳头瘤病毒状态仍然是疾病特异性生存的预后因素（p=0.030），危险比为 0.2（95%CI 0.1-0.9）。
在四分之一的阴茎癌病例中观察到高危型人乳头瘤病毒-DNA。在最近几十年中，未观察到高危型人乳头瘤病毒感染率的显著增加。高危型人乳头瘤病毒-DNA 在阴茎癌中的存在可带来生存优势。
