PTU - Polskie Towarzystwo Urologiczne
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Diagnosis of human papilloma virus (HPV) infection of male genital skin and mucosa
Article published in Urologia Polska 2008/61/Supl. 1.

authors

Leszek Walczak, Sławomir Dutkiewicz, Sławomir Majewski, Stefania Jabłońska, Alojzy Witeska
Klinika Dermatologii i Wenerologii Warszawskiego Uniwersytetu Medycznego
Zakład Profilaktyki i Epidemiologii Onkologicznej Instytutu Zdrowia Publicznego, Wydział Nauk o Zdrowiu Uniwersytetu Humanistyczno-
Przyrodniczego Jana Kochanowskiego w Kielcach oraz Centrum Attis w Warszawie
Centralny Szpital Kliniczny MSWiA w Warszawie

summary

Introduction and objective.

Infection of male genitals with HPV, mainly the penis (mucosa and skin) lead to preneoplastic and neoplastic lesions. Mild lesions (low risk of neoplastic transformation due to infection with 6,11,42,43 and 44 HPV types) include: condylomata acuminata or Buschke-Lowenstein giant condylomata, bowenoid papulosis a Bowen’s disease.Neoplasia is due to oncogenic types, most commonly HPV 16 and 18 and is manifested as penile squamous cell carcinoma developing on the mucous membrane of the prepuce or retroglandular groove which in situ corresponds to (penile interepithelial neoplasia – PIN) PIN III. Predisposing factors include phimosis, inflammation, lichen, papillomas and smoking. Superficial cancers are differentiated and those penetrating are poorly differentiated.
The aim was to assess identification HPV infection in men with macular and papular lesions of the glans, prepuce or in the urethral meatal area.

Materials and methods.

351 men aged 16-85 (mean 52 yrs.) with above described lesions we studied. Peniscopy, urethral smear cytology, polymerase chain reaction - PCR and Hybrid Capture II identification of HPV DNA, cellular immunity tests such as natural killer - NK activity and rosette tests were done in all patients, as well as microscopic pathologic examination of tissue samples. The prevalence of PIN I-III was analyzed retrospectively.

Results.

Low risk (LR) HVP infection was found in 112 (32%), high risk (HR) infection in 172 (49%) and mixed infection in 81 (23%). Only 81 (23%) men were negative for HVP DNA. In pooled LR and HR groups PIN I, PIN II, PIN III (Bowen disease) and invasive cancer were found in 36,21,12 and 10 studied subjects, respectively. Urethral cytology revealed abnormal cells in 63% of patients.

Conclusions.

Men with penile lesions should be subject to detailed examination including peniscopy to exclude precancerous lesions. Cytologic study of scaphoid fossa smear allowed identification of subclinical HPV infection and virologic examinations enabled accurate pathological and clinical diagnosis.