Expressão imuno-histoquímica de trop-2 e her-2 no carcinoma epidermoide de pênis e associação com características histopatológicas de agressividade tumoral

Abstract

Penile squamous cell carcinoma, although uncommon in developed countries, shows high incidence in regions such as Maranhão and is associated with delayed diagnosis, mutilating treatments and poorer prognosis. In this setting of high biological aggressiveness and scarcity of robust markers, TROP-2 stands out as a surface antigen already validated as a therapeutic target in breast and urothelial carcinomas, whereas the HER-2 receptor, classically relevant in other neoplasms, has its role in penile cancer still poorly clarified. Therefore, remains a gap regarding the prognostic value and therapeutic potential of TROP-2 and HER-2 at this site, especially in regions with high incidence, which justifies their investigation. Thus, the aim of this study was to characterize the immunohistochemical expression of TROP-2 and HER-2 in penile squamous cell carcinoma and to evaluate its association with histopathological features of tumor aggressiveness. This is an observational, retrospective, cross sectional study with an exploratory prognostic component that included 57 patients with penile squamous cell carcinoma, in whom the immunohistochemical expression of TROP-2 and HER-2 in tumor samples was analyzed and correlated with clinicopathological variables. TROP-2 positivity predominated, with high expression (score 3+) in around three quarters of tumors, especially in condylomatous and mixed subtypes and in well or moderately differentiated neoplasms, whereas HER-2 expression was rare, restricted to two cases, with no significant associations with histopathological variables or with the risk phenotype. High TROP-2 expression was associated with lower frequency of blood vascular and perineural invasion and with a higher probability of a low pathological risk phenotype. It is concluded that TROP-2 is widely expressed in penile squamous cell carcinoma and is linked to a less aggressive histopathological profile and to lower composite pathological risk, emerging as a potential biomarker to refine biological stratification and as a relevant candidate therapeutic target, whereas HER-2 proved to be infrequent and of limited relevance in the studied population.