Câncer de pênis e fatores associados a metástases em linfonodos inguinais

Santos, Kelly Monteiro dos; Barros, Felipe Dubourcq de; Araújo-Mariz, Carolline

doi:10.33448/rsd-v10i2.12854

Cited by 1 publication

(1 citation statement)

References 15 publications

(26 reference statements)

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“…The association between high ki-67 expression and angiolymphatic and perineural invasion is another important finding of our study and was previously described for PC. Angiolymphatic and perineural invasions are known to be associated with a worse prognosis, and its detection is sometimes influenced by the observer (pathologist) bias, suggesting that IHC for ki-67 can refine the diagnosis and prompt one to search for neural or vascular invasion in the histopathological analysis [ 92 , 93 ].…”

Section: Discussionmentioning

confidence: 99%

A comprehensive analysis of penile cancer in the region with the highest worldwide incidence reveals new insights into the disease

et al. 2022

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Background Although penile cancer (PC) is uncommon in developed countries, it is widespread in developing countries. The state of Maranhão (Northeast, Brazil) has the highest global incidence recorded for PC, and, despite its socioeconomic vulnerability, it has been attributed to human papillomavirus (HPV) infection. This study aimed to determine the histopathological features, the prevalence of HPV infection, and the immunohistochemical profile of PC in Maranhão. Methods A retrospective cohort of 200 PC cases were evaluated. HPV detection was performed using nested-PCR followed by direct sequencing for genotyping. Immunohistochemistry (IHC) was performed using monoclonal antibodies anti-p16INK4a, p53, and ki-67. Results Our data revealed a delay of 17 months in diagnosis, a high rate of penile amputation (96.5%), and HPV infection (80.5%) in patients from Maranhão (Molecular detection). We demonstrated the high rate of HPV in PC also by histopathological and IHC analysis. Most patients presented koilocytosis (75.5%), which was associated with those reporting more than 10 different sexual partners during their lifetime (p = 0.001). IHC revealed frequent p16INK4a overexpression (26.0%) associated with basaloid (p < 0.001) and high-grade tumors (p = 0.008). Interestingly, p16 appears not to be a better prognostic factor in our disease-free survival analysis, as previously reported. We also demonstrated high ki-67 and p53 expression in a subset of cases, which was related to worse prognostic factors such as high-grade tumors, angiolymphatic and perineural invasion, and lymph node metastasis. We found a significant impact of high ki-67 (p = 0.002, log-rank) and p53 (p = 0.032, log-rank) expression on decreasing patients’ survival, as well as grade, pT, stage, pattern, and depth of invasion (p < 0.05, log-rank). Conclusions Our data reaffirmed the high incidence of HPV infection in PC cases from Maranhão and offer new insights into potential factors that may contribute to the high PC incidence in the region. We highlighted the possible association of HPV with worse clinical prognosis factors, differently from what was observed in other regions. Furthermore, our IHC analysis reinforces p16, ki-67, and p53 expression as important diagnosis and/or prognosis biomarkers, potentially used in the clinical setting in emerging countries such as Brazil.

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Section: Discussionmentioning

confidence: 99%