Résumé
【Objective】 To explore the effects of status of lymph vascular invasion (LVI) on the survival of patients with squamous cell carcinoma of the penis (SCCP). 【Methods】 Data of patients diagnosed as SCCP during Jan.1, 2010 and Dec.31, 2019 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier method was used to draw the survival curve of patients with different LVI statuses, and log-rank test was conducted in parallel. Univariate and multivariate Cox regression analyses were used to assess the effects of LVI status on the overall survival. Patients were divided into different subgroups based on stage (localized, regional, and distant metastasis) and grade (well, moderately and poorly differentiated) of tumor, and the effects of LVI status on the overall survival of patients in different subgroups were assessed. 【Results】 A total of 1 435 patients were involved, including 1 102 (76.8%) without LVI and 333 (23.2%) with LVI. Median survival time of patients without LVI and with LVI were 27.5 months and 17.0 months, respectively (χ2=55.028, P<0.001). Cox regression analyses showed LVI was a significant prognostic factor in SCCP patients (HR=1.280, 95%CI:1.044-1.569, P=0.018). In the subgroup analysis, LVI was an independent risk factor affecting the overall survival of patients with localized tumor (HR=1.446, 95%CI:1.009-2.110, P=0.046) and regional tumor (HR=1.323, 95%CI:1.018-1.720, P=0.036);it was also an independent risk factor affecting the overall survival of SCCP patients with well differentiated tumor (HR=2.797, 95%CI:1.573-4.971, P=0.046) and moderately differentiated tumor (HR=1.431, 95%CI:1.071-1.914, P=0.015). 【Conclusion】 LVI status is a significant factor affecting the prognosis of SCCP patients. LVI is an independent risk factor for the overall survival of SCCP patients with localized and regional tumor, moderately differentiated and well differentiated tumor.
Résumé
OBJECTIVE: To investigate microvessel density as a risk factor in squamous cell carcinoma of the penis. METHODS: Fifty patients with penile carcinoma were evaluated retrospectively. The mean age and standard deviation were 60.8±11.8 years. All of them were treated by penectomy and with positive nodes underwent groin lymphadenectomy. Tumor grading was 36 G1 and 24 G2/3. Primary lesion stage was 22 pT1 and 28 pT2-4. Positive inguinal nodes were observed in 18 patients. Selected paraffin embedded sections were submitted to CD34 immunohistochemical analysis by the avidin-biotin-immunoperoxidase method with antigen retrieval. All slides were examined using an automatic analyzer system and the number of micro-vessels in 10 high magnification power fields (400X) were counted in a blind analysis. RESULTS: Median number of microvessels was 631 in G1 versus 695 in G2/3 tumors (p=0.78), and 696 in pT1 versus 566 pT2-4 tumors (p=0.23). The respective data for pN0 patients was 525 and for pN+ was 696 (p=0.01), which is an unexpected result. CONCLUSION: CD34 immunoexpression or microvessel density determined by this method bear no association with tumor grade, stage or prognosis.
Résumé
OBJECTIVE: To investigate the vessel endothelial growth factor (VEGF) as a risk factor in squamous cell carcinoma of the penis (SCCP). METHODS: Forty-seven patients with penile carcinoma were evaluated retrospectively. The mean age and standard deviation were 61.1±11.7 years. All of them were treated by penectomy and those with positive nodes underwent groin lymphadenectomy. Tumor grading was 35 G1 and 12 G2/3. Primary lesion stage was 24 pT1 and 23 pT2-4. Positive inguinal nodes were observed in 15 patients. Selected paraffin embedded sections were submitted to VEGF immunohistochemical analysis by the avidin-biotin-immunoperoxidase method with antigen retrieval. All slides were examined using an automatic analyzer system and the proportion of labeled cells in 10 high magnification power fields (400X) were recorded in a blind analysis. RESULTS: Median (%) labeling index was 2.3 in G1 versus 2.2 in G2/3 tumors (p=0.60), and 4.0 in pT1 versus 1.8 pT2-4 tumors (p=0.10). The respective data for pN0 patients was 2.8 and for pN+ was 2.1 (p=0.20). Survival curves showed no association with patients survival. CONCLUSION: In squamous cell carcinoma of the penis the VEGF immunoexpression has no association with tumor grade or stage, as well as with patient survival.
Résumé
Objetivo - Estudar se a expressão imunohistoquímica do Ki-67 em carcinomas epidermóides de pênis tem relação com a agressividade biológica do tumor. Material e Métodos - Em 26 pacientes portadores da neoplasia fez-se amputação parcial ou total de pênis, em 10 dos quais associou-se linfadenectomia regional por suspeita de metástases. A idade média dos pacientes foi de 61 anos e o tempo de seguimento pós-operatório de 5± 3,2 anos. As peças operatórias conservadas em formol ou parafina foram processadas para marcação imunohistoquímica para o Ki-67 pelo método da avidina-biotina-peroxidase. Resultados - Em 19/26 (73%) dos casos a marcação foi positiva, sendo 13/20 tumores bem diferenciados e 6/6 moderadamente diferenciados. Em 10/16 pacientes com doença localizada o marcador foi positivo, enquanto que essa proporção para os casos de metástases foi 9/10. A sobrevida de 5 anos foi 15/26 (65,4%). A análise estatística não mostrou correlação entre a positividade imunohistoquímica com o grau e estádio da neoplasia, nem com a sobrevida dos pacientes. Conclusão - Não se encontrou relação entre a marcação imunohistoquímica do Ki-67 com a agressividade biológica do tumor.