Introduction Penile carcinoma (PC) is a rare disease, however it is still considered a serious public health problem. The expression of p16INK4a, a protein associated with tumour suppression, can be used as a marker for the presence of high risk HPV DNA. The upregulation of this protein is understood to be an attempt to stop uncontrolled cellular proliferation in response to HPV infection.
Objectives The goal of this study was to estimate the prevalence of HPV DNA and evaluate the expression and correlation of p16INK4a with HPV DNA in patients with PC in Goias, Brazil. Methods: this retrospective cohort study involved 190 patients with PC treated in the UroOncology service of Hospital Araujo Jorge (HAJ), a unit of the Association Against Cancer in Goias (ACCG), from January 2003 to November 2015. The paraffin blocks containing the cancerous tissue fragments were subjected to extraction of viral DNA, subsequently subjected to polymerase chain reaction testing with short PCR fragment (SPF PCR) primers to detect HPV DNA. The marking of the p16INK4a protein was performed with immunohistochemistry, using a commercial kit (Mach 4 Universal HRPPolymer Detection System – Biocare Medical, CA, USA). The slides were evaluated independently by two pathologists.
Results Of the 190 samples tested, 89 (46.8%) (CI 95%: 39.8%–53.9%) showed positive HPV DNA and 98 (51.7.0%) (CI 95%: 33.2 to 53.2) showed expression of p16INK4a. The correlation between the presence of HPV DNA and p16INK4a was 63.6% (CI 95%: 46.3 to 78.6). Although there is no expression of p16INK4a in 100% of cases positive for HPVDNA, there was statistical significance between the presence of viral DNA and expression of p16INK4a (p<0.003).
Conclusion Some studies suggest that the standard knowledge of the expression of the p16INK4a protein may be a useful marker for HPV activity in patients with penile cancer. The results of this study showed that there are significant differences between the expression of this protein in positive and negative HPV DNA samples.
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