title: Prevalence of human papillomavirus in penile malignant tumors: viral genotyping and clinical aspects.
abstract: BACKGROUND
  The human papillomavirus (HPV) prevalence in males has been reported to be between 3.6% and 84%, depending specially on the socioeconomic status. HPV infection has been related as a risk factor for penile cancer. This is a rare tumor, and other risk factors include lack of personal hygiene and men who have not undergone circumcision. Penile cancer is less than 1% of cancers in men in the United States, however, is much more common in some parts of Asia, Africa, and South America, where it accounts for up to 10% of cancers in men. This study aimed to determine the prevalence of HPV-DNA in penile cancers in São Luís, Brazil and to correlate the virus presence to histopathological factors.
  
  
  METHODS
  Tumor paraffin samples of 76 patients with penile carcinoma were tested in order to establish the prevalence and distribution of genotypic HPV using PCR/Nested and automated sequencing. To evaluate the association between HPV types and other clinical and morphological variables, a nonparametric ANOVA was performed using a Kruskal Wallis test, and statistical significance was determined to a value of p < 0.05.
  
  
  RESULTS
  The average age of patients at the time of diagnosis was 66 years ± 17.10. Regarding location, 65.79% of the tumors were located in the glans, and the most common types were vegetative (34.21%) and squamous (98.68%). Most of the lesions ranged in size from 2.1 to 5.0 cm, presenting Jackson I stage and Broders II degree. It was observed that 32 patients had at least one invaded and/or infiltrated structure. Lymph node involvement was observed in 19.76% of the patients, and 21.05% showed an inflammatory process. In the molecular evaluation, HPV infection was observed in 63.15% of the lesions, and the most common type was HPV 16.
  
  
  CONCLUSIONS
  From the statistical analysis, it can be verified that the variables were not associated with infection by the HPV virus. Although penile cancer can result from various risk factors that act in synergy, an HPV virus infection is important for the development of such neoplasm.
authors.affiliation: Tumors and DNA Bank of Maranhão, Federal University of Maranhão (UFMA), São Luís, Brazil. isauradanielli@gmail.com.
authors.forename: Isaura Danielli Borges
authors.initials: ID
authors.lastname: de Sousa
authors.affiliation: Tumors and DNA Bank of Maranhão, Federal University of Maranhão (UFMA), São Luís, Brazil. flavidal@hotmail.com.|Department of Morphology, Federal University of Maranhão (UFMA), São Luís, Brazil. flavidal@hotmail.com.
authors.forename: Flávia Castello Branco
authors.initials: FC
authors.lastname: Vidal
authors.affiliation: José Alencar Gomes da Silva National Cancer Institute, Department of Genetics, Rio de Janeiro, Brazil. jpvidal@gmail.com.
authors.forename: João Paulo Castello
authors.initials: JP
authors.lastname: Branco Vidal
authors.affiliation: Maranhão State Institute of Oncology Aldenora Bello (IMOAB), São Luis, MA, Brazil. geocfdmello@gmail.com.
authors.forename: George Castro Figueira
authors.initials: GC
authors.lastname: de Mello
authors.affiliation: Tumors and DNA Bank of Maranhão, Federal University of Maranhão (UFMA), São Luís, Brazil. cnsd_ma@uol.com.br.
authors.forename: Maria
authors.initials: M
authors.lastname: do Desterro Soares Brandão Nascimento
authors.affiliation: Tumors and DNA Bank of Maranhão, Federal University of Maranhão (UFMA), São Luís, Brazil. luciane2406@yahoo.com.br.|Department of Medicine III, Federal University of Maranhão (UFMA), São Luís, Brazil. luciane2406@yahoo.com.br.
authors.forename: Luciane Maria Oliveira
authors.initials: LM
authors.lastname: Brito
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001938:Brazil / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics* / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000453:epidemiology*; D010412:Penile Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000821:virology*; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment