PENILE INTRAEPITHELIAL NEOPLASIA - SPECIFIC CLINICAL-FEATURES CORRELATE WITH HISTOLOGIC AND VIROLOGICAL FINDINGS

Background. To evaluate the existence of the morphologic features spec ific for penile intraepithelial neoplasia (PIN), 1000 male sexual part ners of women with genital condyloma or intraepithelial neoplasia were studied. Methods. Ninety-two patients who presented with lesions sugg esting intraepithelial neoplasia (pigmented or leukoplastic papules, k eratinized condylomata, or erythroplastic macules) underwent biopsy fo r histologic and virologic studies. Results. Histologic results showed penile intraepithelial neoplasia in 93% of the specimens. Human papil lomavirus (HPV) DNA from potentially oncogenic papillomaviruses was de tected in 75% of patients with Grade I PIN, in 93% of patients with Gr ade II PIN, and in all patients with Grade III PIN. Uncircumcised and circumcised men showed the same rate (52% vs. 45%; odds ratio [OR] = 1 .3; 95% confidence interval, 0.97-1.73) of HPV-associated lesions, whe reas the rate of PIN was significantly higher in uncircumcised men tha n in circumcised men (10% vs. 6%; OR = 1.77; 95% confidence interval, 1.02-3.07). The mean age of patients with Grade III PIN was 7 years ol der then the mean age of patients with Grade I PIN, which suggests a s tep progression similar to that of cervical intraepithelial neoplasia. Conclusion. Morphology seems to be a specific-enough indicator of PIN , More data are needed to determine whether treatment of PIN may contr ibute to preventing cervical or penile cancer. If so, the morphologic criteria here described will be clinically useful.