title: Role of histological findings and pathologic diagnosis for detection of human papillomavirus infection in men.
abstract: Early HPV infection in males is difficult to detect clinically and pathologically. This study assessed histopathology in diagnosing male genital HPV. External genital lesions (n = 352) were biopsied, diagnosed by a dermatopathologist, and HPV genotyped. A subset (n = 167) was diagnosed independently by a second dermatopathologist and also re-evaluated in detail, tabulating the presence of a set of histopathologic characteristics related to HPV infection. Cases that received discrepant diagnoses or HPV-related diagnoses were evaluated by a third dermatopathologist (n = 163). Across dermatopathologists, three-way concordance was fair (k = 0.30). Pairwise concordance for condyloma was fair to good (k = 0.30-0.67) and poor to moderate for penile intraepithelial neoplasia (k = -0.05 to 0.42). Diagnoses were 44-47% sensitive and 65-72% specific for HPV 6/11-containing lesions, and 20-37% sensitive and 98-99% specific for HPV 16/18. Presence of HPV 6/11 was 75-79% sensitive and 35% specific for predicting pathologic diagnosis of condyloma. For diagnosis of penile intraepithelial neoplasia, HPV 16/18 was 95-96% specific but only 40-64% sensitive. Rounded papillomatosis, hypergranulosis, and dilated vessels were significantly (P < 0.05) associated with HPV 6/11. Dysplasia was significantly (P = 0.001) associated with HPV 16/18. Dermatopathologists' diagnoses of early male genital HPV-related lesions appear discordant with low sensitivity, while genotyping may overestimate clinically significant HPV-related disease. Rounded papillomatosis, hypergranulosis, and dilated vessels may help establish diagnosis of early condyloma.
authors.affiliation: University of South Florida Morsani College of Medicine, Tampa, Florida.
authors.forename: Nikki S
authors.initials: NS
authors.lastname: Vyas
authors.affiliation: Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.|Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Pierce Campbell
authors.affiliation: Department of Dermatology & Cutaneous Surgery, University of South Florida, Tampa, Florida.|Department of Pathology and Cell Biology, University of South Florida, Tampa, Florida.
authors.forename: Rahel
authors.initials: R
authors.lastname: Mathew
authors.affiliation: Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.|Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
authors.forename: Martha
authors.initials: M
authors.lastname: Abrahamsen
authors.affiliation: Department of Dermatology & Cutaneous Surgery, University of South Florida, Tampa, Florida.|Department of Pathology and Cell Biology, University of South Florida, Tampa, Florida.
authors.forename: Kaisa
authors.initials: K
authors.lastname: Van der Kooi
authors.affiliation: Department of Dermatology & Cutaneous Surgery, University of South Florida, Tampa, Florida.|Department of Pathology and Cell Biology, University of South Florida, Tampa, Florida.|Pathology and Laboratory Medicine Service, James A. Haley VA Hospital, Tampa, Florida.
authors.forename: Drazen M
authors.initials: DM
authors.lastname: Jukic
authors.affiliation: Department of Pathology, University of Virginia Health System, Charlottesville, Virginia.
authors.forename: Mark H
authors.initials: MH
authors.lastname: Stoler
authors.affiliation: Department of Radiology and Oncology, School of Medicine, University of São Paulo and School of Medical Sciences, Santa Casa de São Paulo, Brazil.
authors.forename: Luisa L
authors.initials: LL
authors.lastname: Villa
authors.affiliation: Reference and Training Center for STD/Aids, São Paulo, Brazil.
authors.forename: Roberto Carvalho
authors.initials: RC
authors.lastname: da Silva
authors.affiliation: Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Morelos, México.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Lazcano-Ponce
authors.affiliation: Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Morelos, México.
authors.forename: Manuel
authors.initials: M
authors.lastname: Quiterio
authors.affiliation: Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Morelos, México.|Unit for Epidemiologic and Health Services Research, Institute of Mexican Social Security, Cuernavaca, Morelos, México.
authors.forename: Jorge
authors.initials: J
authors.lastname: Salmeron
authors.affiliation: Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Sirak
authors.affiliation: Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.|Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
authors.forename: Donna J
authors.initials: DJ
authors.lastname: Ingles
authors.affiliation: Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.|Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
authors.forename: Anna R
authors.initials: AR
authors.lastname: Giuliano
authors.affiliation: Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.|Department of Dermatology & Cutaneous Surgery, University of South Florida, Tampa, Florida.|Department of Pathology and Cell Biology, University of South Florida, Tampa, Florida.|Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.
authors.forename: Jane L
authors.initials: JL
authors.lastname: Messina
mesh_terms: D000328:Adult; D001706:Biopsy; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000473:pathology / Q000821:virology; D003218:Condylomata Acuminata / Q000175:diagnosis / Q000473:pathology / Q000821:virology; D005832:Genital Diseases, Male / Q000175:diagnosis* / Q000473:pathology*; D005838:Genotype; D052140:Human papillomavirus 11 / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity; D052162:Human papillomavirus 16 / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity; D006801:Humans; D008297:Male; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification* / Q000472:pathogenicity; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000473:pathology* / Q000821:virology; D010412:Penile Neoplasms / Q000175:diagnosis* / Q000821:virology*; D010413:Penis / Q000473:pathology; D016133:Polymerase Chain Reaction; D012680:Sensitivity and Specificity
keywords: HPV; PeIN; biopsy; condyloma; histopathology; penile intraepithelial neoplasia