Associação do perfil inflamatório infiltrado no câncer peniano com fatores de risco: potencial como marcador de prognóstico

Abstract

Cancer is the second leading cause of death in the world, rarely occurring in the context of penile cancer in developed countries, but with a high incidence in developing countries, including Brazil. In Brazil, penile cancer also has a polarized distribution, with higher incidences in the north and northeast regions, especially in the state of Maranhão. The objective of this study was to characterize the profile of immune cells infiltrated in penile carcinoma as a possible marker of diagnosis and/or prognosis in patients treated at the referral hospital in Maranhão. To this end, sociodemographic and clinical data were collected from medical records and a fragment of the anatomopathological specimen fixed in buffered formalin for histological processing. Scores were calculated by differential counting of three

random fields analyzed for data analysis and one-way ANOVA tests were applied, with a p- value <0.05 being considered statistically significant. The sociodemographic results showed a

profile of patients residing mainly in the northern mesoregion of Maranhão, indicating risk factors such as low socioeconomic status, low education, presence of phimosis and HPV infection. In the histopathological analyses, 87.5% of the samples presented leukocyte infiltrates, characterizing penile cancer as inflammatory, and 68.7% of cellular alterations characteristic of HPV (koilocytosis) were observed. The correlation analyses associated the histological subtypes, some risk factors such as the presence of phimosis, age, smoking, alcoholism, and more advanced staging of the disease. Cellular alterations suggestive of HPV infection are associated with carcinogenesis and the formation of leukocyte infiltrate, which suggests a modulation of the immune response in the microenvironment, having a worse prognosis. Thus, the present study shows that the profile of patients diagnosed with penile cancer in Maranhão converges with data described in the literature on the clinical and sociodemographic characteristics of the disease, correlating risk factors such as older age, the presence of phimosis in these patients, and previous contact with HPV with worse staging of the disease, suggesting the induction of a favorable inflammatory process in the tumor microenvironment.