Pathological characterization and clinical outcome of penile intraepithelial neoplasia variants: a North American series.

Autor: Straub Hogan MM; Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA., Spieker AJ; Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA., Orejudos M; Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, USA., Gheit T; Infections and Cancer Biology Group, International Agency for Research on Cancer, Lyon, France., Herfs M; Laboratory of Experimental Pathology, University of Liège, Liège, Belgium., Tommasino M; Instituto de Patología e Investigación, Universidad Nacional de Asunción, Asunción, Paraguay., Sanchez DF; Instituto de Patología e Investigación, Universidad Nacional de Asunción, Asunción, Paraguay.; School of Medicine, National University of Asunción, San Lorenzo, Paraguay., Fernandez-Nestosa MJ; Polytechnic School, National University of Asunción, San Lorenzo, Paraguay., Pena MDCR; Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA., Gordetsky JB; Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA., Epstein JI; Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, USA., Canete-Portillo S; Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA., Gellert LL; PathGroup, Brentwood, TN, USA., Prieto Granada CN; Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA., Magi-Galluzzi C; Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA., Cubilla AL; Instituto de Patología e Investigación, Universidad Nacional de Asunción, Asunción, Paraguay., Giannico GA; Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA. giovanna.giannico@vumc.org.
Jazyk: angličtina
Zdroj: Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc [Mod Pathol] 2022 Aug; Vol. 35 (8), pp. 1101-1109. Date of Electronic Publication: 2022 Feb 21.
DOI: 10.1038/s41379-022-01020-y
Abstrakt: Penile intraepithelial neoplasia (PeIN) is classified as human papillomavirus (HPV)- and non-HPV-related. This classification is associated with distinct morphologic subtypes. The natural history and prognosis of PeIN subtypes are not well known. This study aims to evaluate clinicopathological features, HPV status, and outcome of PeIN subtypes. Eighty-two lesions from 64 patients with isolated PeIN were retrospectively reviewed. Mean age was 59 years. Lesions were multicentric in 34% of patients and affected glans (33%), shaft (26%), and foreskin (20%). Histologically, 22% of patients had coexisting lesions, classified as hybrid and mixed. HPV-related PeIN (97%) included basaloid (59%), warty (8%), warty-basaloid (8%), hybrid (19%) and mixed (3%) types. P16 and HPV positivity occurred in 99% and 82% of lesions, respectively. HPV 16 was more common in basaloid PeIN. Multiple genotypes were detected in 35%, more commonly in hybrid PeIN (P = 0.051). Positive margins occurred in 63% of excisions. PeIN recurred in 48% of excisions and 30% of overall repeated procedures, and progression to invasive carcinoma occurred in 2%. At follow-up, 86% of patients had no evidence of disease and 12% were alive with disease. Lichen sclerosus occurred in non-HPV and HPV-related PeIN (100% and 47%).In conclusion, HPV-related and, more specifically basaloid PeIN were the predominant types and preferentially associated with HPV 16. While PeIN had a high recurrence rate, there was a slow and infrequent progression to invasive or metastatic carcinoma with multimodal treatments. Additional studies are needed to understand biology and natural history of PeIN.
(© 2022. The Author(s), under exclusive licence to United States & Canadian Academy of Pathology.)
Databáze: MEDLINE
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