Carla Ferrándiz-Pulido, M.D., from the Hospital Universitari Vall d'Hebron in Barcelona, Spain, and colleagues examined the prevalence of HPV in a retrospective series of 82 patients with PSCC (69 invasive and 13 PeIN). Polymerase chain reaction assay with SPF-10 broad-spectrum primers followed by DNA enzyme immunoassay was used for HPV detection, and genotyping was performed using a reverse hybridization line probe assay.

The researchers identified HPV DNA in 31 of 77 (40.2 percent) PSCC cases (22 of 67 invasive and nine of 10 PeIN). HPV-16 was identified in 25 of 31 (80.6 percent) cases. Most basaloid and warty tumors were hrHPV positive, while only 15 percent of usual PSCC were hrHPV positive. All hrHPV-positive PSCC had an adjacent undifferentiated PeIN. The researchers found that hrHPV infection correlated with strong p16^INK4a immunostaining, and p16^INK4a immunohistochemical overexpression was present in most undifferentiated PeIN. There was better overall survival, although not statistically significant, in both hrHPV-positive and p16^INK4a-positive tumors.

"In this study, we detected hrHPV in 28 percent of PSCC and in 90 percent of PeIN," the authors write. "These results allow identification of a subset of PSCC in which HPV would play a triggering role and give support to the bimodal etiopathogenic hypothesis that distinguishes two different subsets of PSCC."

Abstract
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