Evidence for Multiple Independent Pathways of Penile Carcinogenesis

—      Mark A. Rubin^*, Bernard Kleter, Ming Zhou^*, Gustavo Ayala, Antonio L. Cubilla, Wim G. V. Quint^¶ and Edyta C. Pirog^||

^—        From the Department of Pathology,^*

^—        University of Michigan, Ann Arbor, Michigan; the Delft Diagnostic Laboratory,

^—        Delft, The Netherlands; the Department of Pathology,

^—        Baylor College of Medicine, Houston, Texas; the Department of Pathology,

^—        Universidad Nacional de Asuncion, Asuncion, Paraguay; the Academic Medical Center,^¶

^—        Amsterdam, The Netherlands; and the Department of Pathology,^||

Cornell University, New York, New York

To clarify the role of human papillomavirus (HPV) in penile cancer we evaluated the prevalence of HPV DNA in different histological subtypes of penile carcinoma, dysplasia, and condyloma using a novel, sensitive SPF10 HPV polymerase chain reaction assay and a novel genotyping line probe assay, allowing simultaneous identification of 25 different HPV types. Formalin-fixed, paraffin-embedded tissue samples were collected from the United States and Paraguay. HPV DNA was detected in 42% cases of penile carcinoma, 90% cases of dysplasia, and 100% cases of condyloma. There were significant differences in HPV prevalence in different histological cancer subtypes. Although keratinizing squamous cell carcinoma and verrucous carcinoma were positive for HPV DNA in only 34.9 and 33.3% of cases, respectively, HPV DNA was detected in 80% of basaloid and 100% of warty tumor subtypes. There was no significant difference in HPV prevalence between cases from Paraguay and the United States. In conclusion, the overall prevalence of HPV DNA in penile carcinoma (42%) is lower than that in cervical carcinoma (100%) and similar to vulvar carcinoma (50%). In addition, specific histological subtypes of penile cancer—basaloid and warty—are consistently associated with HPV, however, only a subset of keratinizing and verrucous penile carcinomas is positive for HPV DNA, and thus these two tumor groups seem to develop along different pathogenetic pathways.

Share This