Sharma Prashant Kumar, Panaiyadiyan Sridhar, Kurra Santosh, Kumar Raman, Nayak Brusabhanu, Kaushal Seema, Sharma Alpana, Kumar Rajeev, Seth Amlesh, Singh Prabhjot
Department of Urology, All India Institute of Medical Sciences, New Delhi, India.
Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India.
Indian J Urol. 2022 Jul-Sep;38(3):210-215. doi: 10.4103/iju.iju_41_22. Epub 2022 Jul 1.
Human papillomavirus (HPV) is a known risk factor of penile cancer (PeCa). However, studies evaluating its true association are limited. In this study, we aimed to estimate HPV prevalence and its true association with PeCa in terms of molecular biological activities.
This single-institutional prospective observational study was conducted between June 2016 and August 2019. We included 40 men with PeCa as a study group and 20 age-matched uncircumcised men who underwent circumcision for phimosis as a control group. Both the groups underwent deoxyribonucleic acid isolation for HPV subtyping followed by evaluation of relative E6/E7 messenger ribonucleic acid (mRNA) expression profile and relative telomerase activity in tissue samples. HPV-16 and -18 were categorized as high-risk, whereas HPV-6 and -11 were categorized as low-risk subtypes.
The mean (±standard deviation) age of PeCa was 51 ± 15.9 years. The majority of patients had stage II disease, and the most common procedure done was partial penectomy. The overall prevalence of HPV in PeCa was 42.5% ( = 17) as compared to 20% ( = 4) in controls. Among the subtypes, the most common subtype was HPV-16 noted in 33.3% (8/24) of cases, followed by HPV-18 in 29.2% (7/24) of cases. PeCa tissues had a significantly higher relative E7 mRNA expression for HPV-18 than the control group ( = 0.016). The mean relative telomerase activity was significantly higher in the PeCa tissues than the control group (138.66 vs. 14.46, < 0.001). A significantly higher relative telomerase activity was noted in the PeCa tissues positive for high-risk HPV subtypes than controls (141.90 vs. 14.46, = 0.0008), but not between high-risk HPV-positive and HPV-negative PeCa cases (141.90 vs. 137.03, = 0.79). High-risk subtypes were not associated with tumor stage ( = 0.76) or lymph node metastasis ( = 0.816).
HPV was associated in 42.5% of PeCa cases based on our experience from a single institution. PeCa tissues had a higher relative E7 mRNA expression for HPV-18 and relative telomerase activity as compared to controls suggesting their potential role as surrogate markers of virus-induced tumorigenesis.
人乳头瘤病毒（HPV）是阴茎癌（PeCa）已知的风险因素。然而，评估其真实关联的研究有限。在本研究中，我们旨在从分子生物学活性方面估计HPV的患病率及其与PeCa的真实关联。
本单机构前瞻性观察研究于2016年6月至2019年8月进行。我们纳入了40例阴茎癌患者作为研究组，以及20例年龄匹配的因包茎接受包皮环切术的未割包皮男性作为对照组。两组均进行脱氧核糖核酸分离以进行HPV亚型分型，随后评估组织样本中E6/E7信使核糖核酸（mRNA）的相对表达谱和相对端粒酶活性。HPV-16和-18被归类为高危型，而HPV-6和-11被归类为低危亚型。
阴茎癌患者的平均（±标准差）年龄为51±15.9岁。大多数患者为II期疾病，最常见的手术是部分阴茎切除术。阴茎癌中HPV的总体患病率为42.5%（n = 17），而对照组为20%（n = 4）。在亚型中，最常见的亚型是HPV-16，在33.3%（8/24）的病例中被检测到，其次是HPV-18，在29.2%（7/24）的病例中被检测到。阴茎癌组织中HPV-18的相对E7 mRNA表达明显高于对照组（P = 0.016）。阴茎癌组织中的平均相对端粒酶活性明显高于对照组（138.66对14.46，P < 0.001）。高危HPV亚型阳性的阴茎癌组织中的相对端粒酶活性明显高于对照组（141.90对14.46，P = 0.0008），但高危HPV阳性和HPV阴性的阴茎癌病例之间无明显差异（141.90对137.03，P = 0.79）。高危亚型与肿瘤分期（P = 0.76）或淋巴结转移（P = 0.816）无关。
根据我们单机构的经验，42.5%的阴茎癌病例与HPV有关。与对照组相比，阴茎癌组织中HPV-18的相对E7 mRNA表达和相对端粒酶活性更高，表明它们可能作为病毒诱导肿瘤发生的替代标志物。
