p53 Immunohistochemistry Defines a Subset of Human Papillomavirus-Independent Penile Squamous Cell Carcinomas With Adverse Prognosis.

IF 4.5 1区 医学 Q1 PATHOLOGY
American Journal of Surgical Pathology Pub Date : 2024-11-01 Epub Date: 2024-07-23 DOI:10.1097/PAS.0000000000002291
Isabel Trias, Ferran Algaba, Inés de Torres, Adela Saco, Lorena Marimon, Núria Peñuelas, Laia Diez-Ahijado, Lia Sisuashvili, Katarzyna Darecka, Alba Morató, Marta Del Pino, Carla Ferrándiz-Pulido, María José Ribal, Tarek Ajami, Juan Manuel Corral, Josep Maria Gaya, Oscar Reig, Oriol Ordi, Inmaculada Ribera-Cortada, Adriana García-Herrera, Natalia Rakislova
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引用次数: 0

Abstract

Penile squamous cell carcinoma (PSCC) is classified into 2 prognostically distinct types: human papillomavirus (HPV)-associated and HPV-independent. However, the impact of p53 status on prognosis remains controversial. We correlated HPV and p53 status with the prognosis of a large series of patients with PSCC. p53 was analyzed according to a recently described immunohistochemical (IHC) pattern-based framework that includes 2 normal and 4 abnormal patterns and closely correlates with TP53 mutational status. A total of 122 patients with surgically treated PSCC in 3 hospitals were included. Based on HPV in situ hybridization and p16 and p53 IHC, the tumors were classified into 3 subtypes: HPV-associated, HPV-independent/p53 normal, and HPV-independent/p53 abnormal. All patients were followed up for at least 22 months (median: 56.9 months). Thirty-six tumors (29%) were HPV-associated, 35 (29%) were HPV-independent/p53 normal, and 51 (42%) were HPV-independent/p53 abnormal. Disease-related deaths were observed in 3/36 (8%), 0/35 (0%) and 14/51 (27%) of the patients, respectively ( P < 0.001). A total of 7/14 deaths in the latter group were patients with tumors showing p53 abnormal patterns not recognized in the classic p53 IHC interpretation (basal, null, and cytoplasmic). According to our multivariate analysis, HPV-independent/p53 abnormal tumors and advanced stage were associated with impaired disease-specific survival (hazard ratio = 23.4, 95% CI = 2.7-3095.3; P = 0.001 and 16.3, 95% CI = 1.8-2151.5; P = 0.008, respectively). In conclusion, compared with patients with HPV-associated and HPV-independent/p53-normal PSCC, patients with HPV-independent/p53 abnormal PSCC have worse clinical outcomes. p53 IHC results define 2 prognostic categories in HPV-independent PSCC: HPV-independent/p53-normal tumors as low-risk tumors, whereas HPV-independent/p53-abnormal tumors as aggressive neoplasms.

p53 免疫组化确定了具有不良预后的人类乳头状瘤病毒依赖性阴茎鳞状细胞癌的一个亚群。
阴茎鳞状细胞癌(PSCC)分为两种预后不同的类型:人类乳头瘤病毒(HPV)相关型和HPV独立型。然而,p53 状态对预后的影响仍存在争议。我们将 HPV 和 p53 状态与大量 PSCC 患者的预后相关联。p53 根据最近描述的基于免疫组化(IHC)模式的框架进行分析,该框架包括 2 种正常模式和 4 种异常模式,并与 TP53 突变状态密切相关。研究共纳入了3家医院的122名接受过手术治疗的PSCC患者。根据HPV原位杂交、p16和p53 IHC将肿瘤分为3个亚型:HPV相关型、HPV独立型/p53正常型和HPV独立型/p53异常型。所有患者均接受了至少 22 个月(中位数:56.9 个月)的随访。36例肿瘤(29%)与HPV相关,35例(29%)与HPV无关/p53正常,51例(42%)与HPV无关/p53异常。与疾病相关的死亡病例分别为 3/36(8%)、0/35(0%)和 14/51(27%)(P< 0.001)。后一组中共有 7/14 例死亡患者的肿瘤显示出经典 p53 IHC 解释(基底、无效和胞质)无法识别的 p53 异常模式。根据我们的多变量分析,HPV 依赖性/p53 异常肿瘤和晚期分期与疾病特异性生存受损有关(危险比分别为 23.4,95% CI = 2.7-3095.3; P= 0.001 和 16.3,95% CI = 1.8-2151.5; P= 0.008)。总之,与HPV相关型和HPV独立型/p53正常型PSCC患者相比,HPV独立型/p53异常型PSCC患者的临床预后较差。p53 IHC结果定义了HPV独立型PSCC的两种预后类别:HPV独立型/p53正常型肿瘤为低危肿瘤,而HPV独立型/p53异常型肿瘤为侵袭性肿瘤。
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来源期刊
CiteScore
10.30
自引率
5.40%
发文量
295
审稿时长
1 months
期刊介绍: The American Journal of Surgical Pathology has achieved worldwide recognition for its outstanding coverage of the state of the art in human surgical pathology. In each monthly issue, experts present original articles, review articles, detailed case reports, and special features, enhanced by superb illustrations. Coverage encompasses technical methods, diagnostic aids, and frozen-section diagnosis, in addition to detailed pathologic studies of a wide range of disease entities. Official Journal of The Arthur Purdy Stout Society of Surgical Pathologists and The Gastrointestinal Pathology Society.
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