[en] 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.
Disciplines :
Oncology
Author, co-author :
Straub Hogan, Melissa M; Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
Spieker, Andrew J; Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
Orejudos, Michael; Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, USA
Gheit, Tarik; Infections and Cancer Biology Group, International Agency for Research on Cancer, Lyon, France
Herfs, Michael ; Université de Liège - ULiège > GIGA > GIGA Cancer - Experimental Pathology
Tommasino, Massimo ; Instituto de Patología e Investigación, Universidad Nacional de Asunción, Asunción, Paraguay
Sanchez, Diego F ; Instituto de Patología e Investigación, Universidad Nacional de Asunción, Asunción, Paraguay ; School of Medicine, National University of Asunción, San Lorenzo, Paraguay
Fernandez-Nestosa, Maria Jose; Polytechnic School, National University of Asunción, San Lorenzo, Paraguay
Pena, Maria Del Carmen Rodriguez; Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
Gordetsky, Jennifer B ; Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
Epstein, Jonathan I; Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, USA
Canete-Portillo, Sofia; Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
Gellert, Lan L; PathGroup, Brentwood, TN, USA
Prieto Granada, Carlos Nicolas; Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
Magi-Galluzzi, Cristina ; Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
Cubilla, Antonio L; Instituto de Patología e Investigación, Universidad Nacional de Asunción, Asunción, Paraguay
Giannico, Giovanna A ; Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA. giovanna.giannico@vumc.org
U.S. Department of Health & Human Services | NIH | National Center for Advancing Translational Sciences
Funding text :
This study was supported by the Vanderbilt Institute for Clinical and Translational Research (VICTR) (VR53120, Dr. Giannico), CTSA award No. UL1 TR002243 by the National Center for Advancing Translational Sciences. Its contents are solely the responsibility of the authors and do not necessarily represent official views of the National Center for Advancing Translational Sciences or the National Institutes of Health.
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