Penile squamous cell carcinomas (PSCC) are classified by the World Health Organization into two categories based on their relationship with the human papillomavirus (HPV): HPV-associated and HPV-independent. We compared a cohort of PSCC from Mozambique, a sub-Saharan country in southeast Africa with a high prevalence of HPV and HIV infection, and Spain, a country in southwestern Europe with a low prevalence of HPV and HIV, to study the distribution of the etiopathogenic categories of these tumors in both sites. A total of 79 PSCC were included in the study (28 from Mozambique and 51 from Spain). All cases underwent HPV-DNA polymerase chain reaction (PCR) testing, genotyping, and immunohistochemistry for p16 and p53. Any PSCC showing either p16 overexpression or HPV-DNA in PCR analysis was considered HPV-associated. Overall, 40/79 (50.6%) tumors were classified as HPV-associated and 39 (49.4%) as HPV-independent. The two sites showed marked differences: 25/28 (89.3%) tumors from Mozambique and only 15/51 (29.4%) from Spain were HPV-associated (p < 0.001). HPV16 was the most frequent HPV type identified in 64.0% (16/25) of the HPV-associated tumors from Mozambique, and 60.0% (9/15) from Spain (p = 0.8). On average, patients from Mozambique were almost two decades younger than those from Spain (mean age 50.9 ± 14.9 and 69.2 ± 13.3, respectively [p < 0.001]). In conclusion, significant etiopathogenic differences between PSCC in Mozambique and Spain were observed, with a remarkably high prevalence of HPV-associated tumors in Mozambique and a relatively low prevalence in Spain. These data may have important consequences for primary prevention of PSCC worldwide.
Cancers. 2022 Oct 27*** epublish ***
Carolina Manzotti, Laurina Chulo, Ricardo López Del Campo, Isabel Trias, Marta Del Pino, Ofélia Saúde, Iracema Basílio, Nelson Tchamo, Lucilia Lovane, Cesaltina Lorenzoni, Fabiola Fernandes, Adela Saco, Maria Teresa Rodrigo-Calvo, Lorena Marimon, Mamudo R Ismail, Carla Carrilho, Inmaculada Ribera-Cortada, Jaume Ordi, Natalia Rakislova
Department of Pathology, Hospital Clínic of Barcelona, University of Barcelona, 08036 Barcelona, Spain., Department of Pathology, Maputo Central Hospital, Maputo 1106, Mozambique., Clinical Institute of Gynecology, Obstetrics, and Neonatology, Hospital Clínic of Barcelona, University of Barcelona, 08036 Barcelona, Spain., Department of Urology, Maputo Central Hospital, Maputo 1106, Mozambique.