背景:阴茎鳞状细胞癌(PSCC)可以由人乳头瘤病毒(HPV)感染引起。这项研究调查了TNM分期组或组分肿瘤分期(pT)的预后价值,分化等级(等级),淋巴管浸润(LVI),和结节期(pN)取决于HPV状态。此外,肿瘤参数的值(pT,Grade,和LVI)用于预测节点阳性疾病取决于HPV状态进行了研究。
方法:研究了1973年至2023年在挪威西部接受PSCC治疗的226例患者的储存肿瘤组织的HPVDNA。根据当前的TNM分类重新评估组织病理学变量。从医院记录中记录疾病病程。在Cox回归中包含HPV和TNM分期组之间的相互作用项,可以分析分期组的癌症特异性存活(CSS)是否取决于HPV状态。这也是单独为pT完成的,Grade,LVI,pN。使用具有HPV和肿瘤参数之间的相互作用项的逻辑回归来研究它们的预测值是否取决于HPV状态。
结果:在43%的肿瘤中检测到HPVDNA。按HPV状态分层,HPV状态和TNM分期组之间的Cox回归无显著交互作用项(P=0.74).pT的结果相似(P=0.94),等级(P=.08),LVI(P=.91)和pN(P=.77)。此外,在HPV状态和肿瘤参数pT之间的logistic回归中没有显著的相互作用项,Grade,和LVI(所有P>2)。
结论:这项研究发现,TNM分期组的预后和pT成分,Grade,LVI,pN在PSCC中未被HPV修饰。pT的值,Grade,和预测淋巴结阳性疾病的LVI不受HPV状态的影响。
BACKGROUND: Penile squamous cell carcinoma (PSCC) can develop from human papillomavirus (HPV) infection. This study investigates if the prognostic value of the TNM stage groups or the components tumor stage (pT), grade of differentiation (Grade), lymphovascular invasion (LVI), and nodular stage (pN) depend on HPV status. Also, whether the value of tumor parameters (pT, Grade, and LVI) for predicting node-positive disease depends on HPV status was investigated.
METHODS: Stored tumor tissue from 226 patients treated for PSCC in Western Norway between 1973 and 2023 was investigated for HPV DNA. Histopathological variables were reevaluated according to the current TNM classification. Disease course was registered from hospital records. Inclusion of an interaction term between HPV and TNM stage groups in Cox regression enabled analysis of whether cancer-specific survival (CSS) of the stage groups depended on HPV status. This was also done separately for pT, Grade, LVI, and pN. Logistic regression with interaction terms between HPV and the tumor parameters were used to investigate if their predictive value depended on HPV status.
RESULTS: HPV DNA was detected in 43% of the tumors. Stratified by HPV status, there was no significant interaction term in the Cox regression between HPV status and TNM stage groups (P = .74). Similar results were found for pT (P = .94), Grade (P = .08), LVI (P = .91) and pN (P = .77). Moreover, there were no significant interaction terms in the logistic regression between HPV status and the tumor parameters pT, Grade, and LVI (all P > .2).
CONCLUSIONS: This study found that prognosis of the TNM stage groups and the components pT, Grade, LVI, and pN were not modified by HPV in PSCC. The value of pT, Grade, and LVI for predicting lymph node-positive disease was not affected by HPV status.