Fernández-Nestosa María José, Guimerà Nuria, Sanchez Diego F, Cañete-Portillo Sofía, Lobatti Antonella, Velazquez Elsa F, Jenkins David, Quint Wim, Cubilla Antonio L
Universidad Nacional de Asunción, Asunción, Paraguay.
DDL Diagnostic Laboratory, Rijswijk, Netherlands.
Int J Surg Pathol. 2020 May;28(3):265-272. doi: 10.1177/1066896919887802. Epub 2019 Nov 17.
Penile intraepithelial neoplasia (PeIN) is currently classified in human papillomavirus (HPV)- and non-HPV-related subtypes with variable HPV genotypes. PeINs are frequently associated with other intraepithelial lesions in the same specimen. The aim of this study was to detect and compare HPV genotypes in PeINs and associated lesions using high-precision laser capture microdissection-polymerase chain reaction and p16 immunostaining. We evaluated resected penile specimens from 8 patients and identified 33 PeINs and 54 associated lesions. The most common subtype was warty PeIN, followed by warty-basaloid and basaloid PeIN. Associated lesions were classical condylomas (17 cases), atypical classical condylomas (2 cases), flat condylomas (9 cases), atypical flat condylomas (6 cases), flat lesions with mild atypia (12 cases), and squamous hyperplasia (8 cases). After a comparison, identical HPV genotypes were found in PeIN and associated lesions in the majority of the patients (7 of 8 patients). HPV16 was the most common genotype present in both PeIN and corresponding associated lesion (50% of the patients). Nonspecific flat lesions with mild atypia, classical condylomas, and atypical condylomas were the type of associated lesions most commonly related to HPV16. Other high-risk HPV genotypes present in PeIN and associated nonspecific flat lesion with mild atypia were HPV35 and HPV39. In this study of HPV in the microenvironment of penile precancerous lesions, we identified identical high-risk HPV genotypes in PeIN and classical, flat, or atypical condylomas and, specially, in nonspecific flat lesions with mild atypia. It is possible that some of these lesions represent hitherto unrecognized precancerous lesions.
阴茎上皮内瘤变（PeIN）目前分为与人乳头瘤病毒（HPV）相关和非HPV相关的亚型，HPV基因型各异。PeIN常与同一标本中的其他上皮内病变相关。本研究的目的是使用高精度激光捕获显微切割-聚合酶链反应和p16免疫染色检测并比较PeIN及相关病变中的HPV基因型。我们评估了8例患者切除的阴茎标本，识别出33个PeIN和54个相关病变。最常见的亚型是疣状PeIN，其次是疣状-基底样和基底样PeIN。相关病变包括典型湿疣（17例）、非典型典型湿疣（2例）、扁平湿疣（9例）、非典型扁平湿疣（6例）、轻度异型性扁平病变（12例）和鳞状上皮增生（8例）。经过比较，大多数患者（8例中的7例）的PeIN和相关病变中发现了相同的HPV基因型。HPV16是PeIN和相应相关病变中最常见的基因型（占患者的50%）。轻度异型性非特异性扁平病变、典型湿疣和非典型湿疣是与HPV16最常相关的相关病变类型。PeIN和轻度异型性相关非特异性扁平病变中存在的其他高危HPV基因型是HPV35和HPV39。在这项关于阴茎癌前病变微环境中HPV的研究中，我们在PeIN与典型、扁平或非典型湿疣中，特别是在轻度异型性非特异性扁平病变中，识别出相同的高危HPV基因型。这些病变中的一些可能代表迄今未被认识的癌前病变。
