Análise da expressão imuno-histoquímica de biomarcadores teciduais no carcinoma de células escamosas de pênis

Abstract

Penile cancer is a rare urological malignancy in developed countries; however, it has a high incidence in developing countries. Penile squamous cell carcinoma (PSCC) is the most common histological type, Several biomarkers have recently been studied trying to better understand tumor changes in tissues. However, there are few studies evaluating the expression of biomarkers in penile cancer and its correlations with prognostic factors. Due to the lack of data, treatment options are limited. Objective: To evaluate the immunohistochemical expression of survivin, Ki67, p16 and PD-L1 in PSCC and to verify its association with established prognostic factors and 5-year survival. Forty patients with PSCC and submitted to partial or total penectomy between 1998 and 2016 at the Urology Department of the São Lucas Hospital of PUC/RS were included. Five out of 40 were excluded due to lack of data. Survivin was expressed in nine patients (25.7%). Mortality in the survivin+ group was significantly higher (HR of 3.73 and 95% CI ranging from 1.25 to 11.12; p=0.018). PD-L1 was expressed in 18 patients (51.4%), predominantly in grade II and grade III lesions (61.1% and 16.6%). In patients with lymph node involvement, 69.2% were PD-L1+. PD-L1+ patients presented larger tumors (4.25cm X 2.6cm; p=0.027), with higher cellularity, evidenced by correlation with Ki67>10% in 80% of patients (p=0.006). There was a statistical correlation between PD-L1+ and p16 expression (p=0.002). Survivin expression seems to be associated with tumor aggressiveness and higher mortality rate in CCEP. PD-L1 expression may be associated with p16 expression, with larger tumors and with worse clinical outcome.