De Bacco Mateus W, Pires Iago Z, Marçal Josenel M B, Wagner Mário B, Fay André P, Averbeck Márcio A, Carvalhal Gustavo F
Department of Urology, São Lucas Hospital, Pontifical Catholic University of Rio Grande Do Sul, Porto Alegre, 90619-900, Brazil.
School of Medicine, Pontifical Catholic University of Rio Grande Do Sul, Porto Alegre, 90619-900, Brazil.
Int Urol Nephrol. 2025 Jul 21. doi: 10.1007/s11255-025-04672-2.
The present study evaluated Survivin and Ki-67 immunohistochemical expression in squamous cell carcinoma of the penis and its association with clinicopathological features and outcomes.
A retrospective cohort study, from 1998 to 2016, was conducted at a tertiary hospital in Brazil, utilizing a convenience sample. The study collected clinical characteristics, pathological features, and outcomes. Immunohistochemical expressions of Survivin and Ki-67 were performed on formalin-fixed paraffin-embedded specimens from patients with PSCC. Survivin positivity (Survivin +) was defined as any staining in more than 5% of tumor cells, while Ki-67 positivity was defined as any staining in more than 10%. The Mann-Whitney U test and Fisher's exact test were used to perform the associations. Kaplan-Meier curves with log-rank were used to estimate survival.
Forty patients undergoing partial or total penectomy were selected, with five subsequently excluded. Among the remaining 35 patients, 15 (42.8%) were Ki-67 positive, and 9 (25.7%) were Survivin + . Ki-67 expression did not demonstrate association with higher tumor grade (73.3% for grades II and III vs. 55% for grade II in the Ki-67 < 10% group; p = 0.06), larger lesions (p = 0.05), or survival outcomes (HR 1.66; 95% CI 0.56-4.98; p = 0.36). Survivin + was more common in grade II and III than grade I (77.8% vs. 22.1; p = 0.027), and Survivin + patients were correlated with worse overall survival (HR 3.73; 95%CI 1.25-11.12; p = 0.01).
Ki-67 expression does not seem to have an impact on clinicopathological features and overall survival. The expression of survivin seems to be promising in detecting penile squamous cell carcinoma patients with a worse prognosis.
本研究评估了生存素（Survivin）和Ki-67在阴茎鳞状细胞癌中的免疫组化表达及其与临床病理特征和预后的关系。
1998年至2016年在巴西一家三级医院进行了一项回顾性队列研究，采用便利抽样。该研究收集了临床特征、病理特征和预后情况。对阴茎鳞状细胞癌患者福尔马林固定石蜡包埋标本进行生存素和Ki-67的免疫组化表达检测。生存素阳性（Survivin+）定义为肿瘤细胞中超过5%出现任何染色，而Ki-67阳性定义为超过10%出现任何染色。采用曼-惠特尼U检验和费舍尔精确检验进行相关性分析。使用带有对数秩检验的Kaplan-Meier曲线估计生存率。
选择40例行部分或全阴茎切除术的患者，其中5例随后被排除。在其余35例患者中，15例（42.8%）Ki-67阳性，9例（25.7%）Survivin+。Ki-67表达与较高肿瘤分级（Ki-67<10%组中II级和III级为73.3%，II级为55%；p=0.06）、较大病变（p=0.05）或生存结果（风险比1.66；95%置信区间0.56 - 4.98；p=0.36）无相关性。Survivin+在II级和III级中比I级更常见（77.8%对22.1%；p=0.027），且Survivin+患者与较差的总生存率相关（风险比3.73；95%置信区间1.25 - 11.12；p=0.01）。
Ki-67表达似乎对临床病理特征和总生存率无影响。生存素的表达在检测预后较差的阴茎鳞状细胞癌患者方面似乎很有前景。
