Prevalence of human papillomavirus and implication on survival in Chinese penile cancer
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ORIGINAL ARTICLE
Prevalence of human papillomavirus and implication on survival in Chinese penile cancer Chengbiao Chu 1,2 & Keming Chen 1,2 & Xingliang Tan 1,3 & Jiangli Lu 1,2 & Yuanzhong Yang 1,2 & YiJun Zhang 1,2 & Kai Yao 1,3 & Yun Cao 1,2 Received: 6 January 2020 / Revised: 7 April 2020 / Accepted: 27 April 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract We assessed the prevalence of HPV DNA in a large series of Chinese penile cancer and examine its association with the histological subtype, p16INK4a expression, and prognosis. We pathologically categorized 226 invasive penile squamous cell carcinomas and assessed HPV genotyping by real-time PCR and p16INK4a immunohistochemistry. The results were correlated with histopathological and clinical parameters and disease-specific survival (DSS). HPV DNA was detected in 32.7% (74/226) of penile cancer cases. The most frequent genotype was HPV 16 (64/74, 86.5%), followed by HPV 18 (6/74, 8.1%). Fifty-nine (26.1%) cases were positive for the p16INK4a expression, and p16INK4a expression had a sensitivity of 56.8% (95% CI, 45.2– 68.3%) and a specificity of 88.8% (95% CI, 83.8–93.9%) for defining HPV status. HPV DNA (P = 0.019), p16INK4a (P = 0.038), age (P = 0.018), grade of differentiation (P = 0.001), lymph nodes (P < 0.001), T stage (P < 0.001), M stage (P < 0.001), and lymphovascular invasion (LVI, P = 0.001) were prognostic factors for DSS. HPV-positivity (HR 0.334; 95% CI, 0.158–0.705, P = 0.004) was still a significant prognostic factor for DSS in the multivariate Cox regression model. HPV DNA was observed in one third of Chinese penile carcinoma cases. The p16INK4a expression can indicate high-risk human papillomavirus (HR-HPV). HPV-positive penile tumors confer a survival benefit over HPV-negative tumors. Keywords Penile cancer . HPV . p16INK4a . Prevalence . Survival
Introduction Penile cancer (PC) is a rare and highly disabling disease with an annual increase of 26,300 new cases worldwide [15]. The overall incidence of PC was 0.6/105 and mortality was 0.18/ Chengbiao Chu, Keming Chen and Xingliang Tan contributed equally to this work. This article is part of the Topical Collection on Quality in Pathology * Kai Yao [email protected] * Yun Cao [email protected] 1
State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, People’s Republic of China
2
Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, People’s Republic of China
3
Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, People’s Republic of China
105 in Chinese male in 2011 reported by the National Central Cancer Registry (NCCR) of China [26]. According to previous research [11, 17], the prevalence of penile cancer has been found to be related to a variety of factors, such as HPV, phimosis, poor sanitation, smoking, multiple sexual partners, genital warts, or other sexually transmitted diseases. Human papillomavirus (HPV)
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