University Hospital of Federal University of Maranhão (UFMA), Barão de Itapari Street, Centro, São Luís, Brazil.
Department of Radiology, University Clinic Hospital of Estadual University of Campinas, Campinas, Brazil.
Sci Rep. 2020 Feb 19;10(1):2965. doi: 10.1038/s41598-020-59831-5.
To determine the epidemiological, histopathological, and clinical characteristics of patients diagnosed with penile cancer in the Brazilian state of Maranhão, the region with the highest incidence worldwide. One hundred and sixteen penile cancer patients were interviewed from July 2016 to October 2018. The majority of patients lived in a rural area (57%), worked in farming (58%), had a low level of schooling or no schooling (90%), and were married or in a stable relationship (74%). The mean age was 60.4 ± 16.51 years (range, 23-93 years). Phimosis (66%), poor/moderate genital hygiene (73%), history of sexually transmitted infections (55%), and zoophilia (60%) were found in the majority of patients. Most patients had their first sexual encounter at 16.2 ± 2.8 years (range, 10-25 years), and 75% had >6 sexual partners. The most common initial symptom was pruritus (37%), and most patients waited to seek treatment (average time to treatment, 18.9 months; range, 2-84 months). Human papillomavirus (HPV)-related histologies were observed in 62% of patients. Most patients had histological grades II or III (87%), stage ≥T2 disease (84%), and lymphadenopathy at admission (42%). Penectomy was performed in 96% of patients. The population with penile cancer in the region of highest incidence in the world is marked by low socioeconomic status, high prevalence of HPV infection, and phimosis. The delay in seeking treatment is related to a very high rate of advanced cancer and aggressive surgical treatment. The high prevalence of young patients was also a striking feature.
为了确定巴西马拉尼昂州（世界上发病率最高的地区）诊断为阴茎癌患者的流行病学、组织病理学和临床特征，我们对 2016 年 7 月至 2018 年 10 月的 116 名阴茎癌患者进行了访谈。大多数患者居住在农村地区（57%），从事农业工作（58%），文化程度低或没有文化（90%），已婚或处于稳定关系（74%）。平均年龄为 60.4 ± 16.51 岁（范围，23-93 岁）。大多数患者存在包茎（66%）、生殖器卫生差/中等（73%）、性传播感染史（55%）和兽交史（60%）。大多数患者初次性行为发生在 16.2 ± 2.8 岁（范围，10-25 岁），75%的患者有 >6 个性伴侣。最常见的首发症状是瘙痒（37%），大多数患者选择延迟治疗（平均治疗时间为 18.9 个月；范围，2-84 个月）。62%的患者存在与 HPV 相关的组织学特征。大多数患者的组织学分级为 II 级或 III 级（87%）、T2 期及以上疾病（84%）和入院时存在淋巴结病（42%）。96%的患者接受了阴茎切除术。世界上发病率最高地区的阴茎癌患者人群具有低社会经济地位、HPV 感染率高和包茎的特点。延迟治疗与癌症晚期和侵袭性手术治疗的高发生率有关。年轻患者的高患病率也是一个显著特征。
