Human papillomavirus genotypes and P16INK4A expression in squamous penile carcinoma in Mexican patients.

BACKGROUND: Approximately 50% of cases of penile carcinoma (PeCa), a rare neoplasm worldwide, are associated with human papillomavirus (HPV). However, the detection of HPV-DNA is not sufficient to consider it the etiological factor in the development of this type of cancer. Currently, the overexpression of P16INK4A is used as a surrogate biomarker of HPV carcinogenesis. Information on PeCa in Mexico is scarce, particularly regarding cases related to HPV and genotype frequency. OBJECTIVE: To evaluate the presence of HPV, its genotypes, and the presence of multiple genotypes, and the expression of P16INK4A, as well as its clinical and histopathological parameters. METHODS: For HPV-DNA detection and P16INK4A expression, we used the INNO-LiPA® test and immunohistochemistry, respectively. RESULTS: Sixty cases of PeCa were evaluated, of which 75% were HPV-non-related histological variants. We found that 58.9% (33/56) of PeCa cases were HPV-DNA positive, while 30.9% of the cases evaluated (17/55) were positive for P16INK4A. HPV16 was the main genotype in 42.9% of the cases, followed by HPV52 in 7.1% and HPV18 in 5.4%. Within the HPV-positive cases, 27.3% had multiple genotypes. All HPV-positive patients under the age of 45 years were positive only for HPV16. CONCLUSIONS: HPV16 was the most commonly detected genotype in PeCa. HPV 31, 35 and 39 were infrequent; however, they were related to a single infection and P16INK4A overexpression; thus, they seem to be relevant in PeCa carcinogenesis. Our results suggest that P16INK4A overexpression could be useful for the classification of HPV-related PeCa. The role of multiple HPV genotypes in the development and prognosis of PeCa is still not completely understood. Thus, it is necessary to define criteria to establish reliable ways to classify HPV-related PeCa that could lead to optimal therapeutic approaches.

[Subtotal-supracrioid laryngectomy (SCSL): the importance of the histopathological analysis]. / Laringectomía subtotal supracricoidea (LSSC): la importancia del análisis histopatológico.

The purpose of conservative surgical treatment of laryngeal cancer is to obtain cancer control with preservation of laryngeal function, and in turn, the preservation of laryngeal function should be understood as the preservation of the patient's ability to ventilate in the normal way without tracheostomy and without aspiration and maintaining intelligible speech. This objective is achieved by maintaining a balance between two fundamental aspects: proper patient selection (based on tumor extension and preoperative laryngeal function) and an adequate histopathological analysis of the surgical specimen. Supracricoid subtotal laryngectomy (SCSL) is the voice conservative surgical technique which offers the best possibility of control in patients with locally advanced laryngeal cancer, and the proper histopathological analysis allows staging and selecting patients eligible for adjuvant therapy, avoiding unnecessary therapies, and allows design of a monitoring and surveillance program based on risk factors. The aim of this manuscript is to highlight key points in the histopathological evaluation of the surgical specimen of SCSL. The proper communication between the surgeon and pathologist, offering complete information on preoperative clinical evaluation and the knowledge of the key points in the evaluation of the surgical specimen (sites of tumor leakage and surgical resection margins) are fundamental parameters to achieve a proper histopathologic evaluation of the surgical specimen.

Human Papillomavirus-Related Recurrent Multiphenotypic Sinonasal Carcinoma With HPV Genotype 56 Detected by HPV Direct Flow CHIP.

Human Papillomavirus-related multiphenotypic sinonasal carcinoma is a rare, and recently described neoplasm, defined by its association with high-risk Human Papillomavirus, which exclusively affects the sinonasal tract and simulates salivary gland tumors. Due to the infrequency of this neoplasm and the lack of knowledge of its pathological characteristics, it is susceptible to diagnostic error. We describe the clinical-radiological findings of a 54-year-old man with multiphenotypic sinonasal carcinoma related to Human Papillomavirus genotype 56. The diagnosis of multiphenotypic sinonasal carcinoma was suspected by light microscopy and was corroborated by immunohistochemistry and polymerase chain reaction (PCR) analysis. The patient was subsequently treated with 63.6 gray radiotherapies. He is currently alive after a follow-up of 20 months, with a recurrence of the disease. In conclusion, multiphenotypic sinonasal carcinoma is an unusual neoplasm, which is not well recognized and can be confused with adenoid cystic carcinoma. However, multiphenotypic sinonasal carcinoma should be included in the differential diagnosis as we encounter sinonasal tumors, which by histology present tubular, cribriform, and solid growth patterns, accompanied by dysplasia or carcinoma in situ in the superficial mucosa. In this case, it is necessary to perform immunohistochemistry for p16INK4A or PCR to confirm the presence of high-risk Human Papilloma Virus, which would confirm the diagnosis.

Cancer Incidence in Merida, Mexico 2015-2018: First Report from the Population-based Cancer Registry.

BACKGROUND: Cancer registries are essential for monitoring cancer burden and patterns, and document changes in time for cancer control. Hereby, we present the first results of four years of the Merida population-based cancer registry in Mexico. METHODS: The registry collects data on all new cancers diagnosed since 2015 using both active and passive methods including a total of 104 information sources. Definitions and coding follow international standards. Using CanReg5 software, age-standardized incidence rates (ASR/100,000 person years) were computed by direct method using the world standard population. RESULTS: A total of 5684 new cancer cases were registered during 2015-2018, 2321 in males and 3363 in females corresponding to age-adjusted incidence rates (ASR per 100,000) of 128.5, and 153.1, respectively. Most frequent cancers among males were prostate cancer (ASR 29.8), lymphomas (ASR 10.9) and colorectal cancer (ASR 9.7) while among females it was breast cancer (ASR 49.3), cervical cancer (ASR 17.5) and corpus uteri (ASR 11.5). Childhood cancers (0-14 year) represented 2.9% of all cancers, with leukemias accounting for 52% of the new cases. Overall, 87.6% of new cases were microscopically verified. CONCLUSIONS: The data reported provide information on the cancer profile in Merida. Prostate and breast cancer are the main incident cancers. Cervical cancers present high rates among women, while lymphomas and liver cancer data merit further exploration. Efforts to support the Merida cancer registry as well as other registries in Mexico need to be pursued in order to have locally recorded data to support cancer control measures.

Retrospective analysis of the clinical presentation and imaging of eight primary benign mediastinal schwannomas.

OBJECTIVE: Mediastinal schwannomas are sometimes confused with other neoplasms during initial radiological studies, especially when there is a history of cancer in another area. In these cases, a more accurate analysis using computed tomography (CT) or even magnetic resonance (MRI) is required. Our study aimed to perform a retrospective analysis of the clinical and imaging features for a series of patients with mediastinal schwannomas that were confirmed by histology and immunohistochemistry. RESULTS: We found eight patients, five men and three women, with an average age of 51 years for this study. The main signs and symptoms at diagnosis were chest pain, dyspnea, cough, and dysphagia. CT showed that the tumor was located in the posterior compartment of the chest in 7/8 cases. Tumors > 10 cm were more heterogeneous and showed cystic changes. All patients underwent posterolateral thoracotomy, and radiological follow-up showed no evidence of recurrence. Histological analysis was considered the gold standard to confirm diagnosis, along with at least one neurogenic IHC marker. In conclusion, mediastinal schwannomas are benign encapsulated tumors. According to CT, schwannomas > 10 cm show cystic degeneration more frequently. Posterolateral thoracotomy allows complete resection and is considered the surgical approach of choice.

Prevalence of HPV in Mexican Patients with Head and Neck Squamous Carcinoma and Identification of Potential Prognostic Biomarkers.

Head and neck squamous cell carcinomas (HNSCC) show a variety of biological and clinical characteristics that could depend on the association with the human papillomavirus (HPV). Biological and clinical characterization is essential to stratify patients based on prognostic and predictive factors. Reports on HNSCC are scarce in Mexico. Herein, we analyzed 414 Mexican patients with HNSCC, including oropharynx (OPSCC), larynx (LASCC), and oral cavity (OCSCC), and identified HPV DNA and p16 expression. Global gene expression profiles were analyzed in 25 HPV+/p16+ vs. HPV-/p16- cases. We found 32.3% p16+ and 22.3% HPV+ samples, HPV 16, 18, 39, 52, and 31 being the most frequent genotypes. For OPSCC, LASCC and OCSCC, 39.2, 14.7, and 9.6% were HPV+/p16+, respectively. High expression of SLIRP, KLF10, AREG, and LIMA was associated with poor survival; in contrast, high expression of MYB and SYCP2 correlated with better survival. In HPV+ cases, high expression of SLC25A39 and GJB2 was associated with poor survival. Likewise, EGFR, IL-1, IL-6, JAK-STAT, WNT, NOTCH, and ESR1 signaling pathways were downregulated in HPV+ cases. CSF1R, MYC, and SRC genes were identified as key hubs and therapeutic targets. Our study offers information regarding the molecular and clinical characteristics of HNSCC in Mexican patients.

The expression of transcription factor BORIS and its association with the estrogen receptor beta (ER-ß) in cervical carcinogenesis.

BORIS is a transcription factor aberrantly expressed in human cancers that can regulate the expression of estrogen receptors in endometrial cancer and breast cancer. We evaluated the expression of BORIS and the estrogen receptors alpha (ER-α) and beta (ER-ß) in ten cell lines derived from cervical cancer using RT-PCR and Western-blot. We also evaluated 54 cervical tissues: normal epithelia, low-grade intraepithelial lesions (LSIL), high-grade intraepithelial lesions (HSIL), and invasive squamous carcinomas (SC) using immunohistochemistry. In the cell lines, BORIS mRNA and protein expressions are associated with ER-ß expression but not with ER-α expression. In the normal cervical epithelium, ER-α and ER-ß were expressed but the BORIS protein was not detected. In the LSIL samples, BORIS, ER-α and ER-ß were expressed; however, in the HSIL samples, only the BORIS and ER-ß expressions were detected, but ER-α expression was minimal or null. In the SC, only BORIS and ER-ß were detected. In summary, the results show that the expressions of BORIS and ER-ß increase while the expression of ER-α decreases according to the severity of the lesions. These results suggest synergistic roles for BORIS and ER-ß during cervical cancer progression with a possible regulation of the estrogen receptors by BORIS in the development of cervical cancer; however, more detailed studies are needed to confirm this suggestion and to determine the precise role of BORIS in cervical cancer.

[Nasal cavity angiosarcoma: a case report and literature review]. / Angiosarcoma de cavidad nasal: informe de un caso y revisión de la literatura.

Sarcomas constitute 5% of all of head and neck neoplasms. Angiosarcomas comprise 2% of all soft tissue tumors, 60% appear in skin and soft tissue, 50% in the head and neck and only 4% are present in the upper aerodigestive tract. We report a case of a 52 year old healthy woman with headache, weeping, foreign body sensation in the left nostril and epixtasis. The TAC identified a tumor in the left nostril that invaded the osseous lamina of the skull. The histopathologic diagnosis was angiosarcoma. We carried out a literature review and analysis from 1976 to 2004. Agiosarcomas of the upper aerodigestive tract have a better prognosis and long term survival free of disease than their soft tissue and skin counterparts. Recurrence is strongly correlated with positive resection margins. Complete surgery and radiotherapy are considered the optimal treatment schemes.

[Histopathologic study of the frontolateral laryngectomy specimen: topics of clinical interest]. / Estudio histopatológico de la pieza de laringectomía frontolateral. Puntos de interés clínico.

Frontolateral laryngectomy is a surgical procedure that allows removal of a vocal cord, anterior commissure, one third of the healthy vocal cord and the thyroid cartilage keel. It is indicated in patients with T1a and T1b glottic-located carcinomas with adverse prognosis factors and selected T2 cases. The success relies on appropriate tumor excision. In order to make an assessment, we need to know the critical topics of clinic interest in the histopathologic study of the specimen. The objective is to analyze which are the significant factors to histologically assess in frontolateral laryngectomy and to report the histological study technique conducted at the Oncology Hospital of the National Medical Center of the Mexican Social Security Institute. According to the critical sites in the surgical technique and significant for local tumor recurrence, we report the histological study technique followed for the frontolateral laryngectomy specimens. The factors to assess in the frontolateral laryngectomy specimen are the anterior third part of the healthy cord, the paraglottic space and the crico-vocal ligament. The pathologic study technique reported herein allows us to satisfactorily assess these risk factors. Macroscopic tumor excision is not sufficient, and a satisfactory histological analysis is required that will allow us to assess the critical sites where there may be residual tumor. These may translate into a higher possibility of tumor recurrence for the patient. Communication between pathologists and surgeons is essential to achieve success in this procedure.