Prevalência e genotipagem do papilomavírus humano em carcinomas epidermóides penianos de pacientes do Estado do Maranhão

Abstract

Human papillomavirus (HPV) is the etiologic agent of one of the most common sexually transmitted infections (STIs). According to the oncogenic potential, it is classified in low risk and high risk; high risk subtypes cause lesions that may progress to invasive carcinomas and has been recognized as a possible etiologic agent in penile carcinoma. Brazil has one of the highest incidences of penile cancer in the world. The general objective of this work is associate HPV infection with the histopathological profile of squamous cell carcinomas in patients from the State of Maranhão. This is a prospective analytical study of 29 samples of patients who underwent penectomy surgery at the Aldenora Bello Institute of Oncology of Maranhão. Sociodemographic data were collected through a questionnaire applied to the patients, clinical and histopathological data were collected from the medical records. Tumor samples were collected during penectomy surgeries, and the following steps were performed at the laboratory: DNA extraction and quantification, Nested PCR with PGMY and GP + primers for HPV detection, visualization of amplified products, purification of the PCR product and automated sequencing. The sequencing products were decoded through the BLAST program. Data were analyzed through the SPSS statistical program, with a 5% level of significance. It was observed that the majority of the men were over 60 years of age (69%), had stable marital union (75.9%), family income of up to one minimum wage (75.9%), were illiterate (55. 2%), lived in countryside towns (79.3%), reported using tobacco at some moment in their lives (62%). Regarding sexual habits, 62.1% reported not having performed circumcision, 41.4% had a previous STD, 72.4% had never used a condom, 48.3% had the first intercourse before age 18. The presence of HPV was detected in 69% of the cases, among the viral types, HPV 16 was the most prevalent (55.5%). Regarding to lesion, 51.7% of the cases presented more than one affected region, and the glans was affected in 93.1% of the cases. The most prevalent type of lesion was ulceration (51.7%). Among the histopathological classifications, 41.4% of the samples were classified in degree I of the Broders scale, 27.7% in stage T1 of the TNM staging and according to the Jackson classification, both stages I and II presented the same prevalence, 27.6% of samples. There was no statistically significant difference between the variables evaluated and the presence of HPV. Low education, low income and no circumcision were highly observed in the study, being possible to correlate such variables with the increase of the risk of penile cancer development. The presence of HPV in 69% of the samples and the prevalence of high risk subtypes suggest the need for more actions to prevent the spread of HPV over the population