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Impact of Copy-number Alterations on Human Papillomavirus (HPV)-Induced and HPV-Independent Penile Cancers

delete2026-04-22
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M
Mikhail Ermakov
S
Sigrid Regauer
K
Karl Kashofer *
DOI:10.1016/j.labinv.2026.106129delete
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Abstract

Abstract

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Penile squamous cell carcinomas (SCC) develop via a transforming human papillomavirus (HPV) infection or independent of HPV. We assessed the role of copy-number alterations (CNA) affecting chromosome arms, oncogenes and tumor suppressor genes (TSG) in 121 penile SCC (52% HPV-associated and 48% HPV-independent) using shallow whole-genome sequencing. CNA were common and complex, with frequent co-occurrences. Neither etiology had exclusive CNA. Arm-level changes included gains of 3q and 8q (48% each), 1q (36%), 1p (26%), 9q (36%) and 9p (31%) and losses of 19p (48%), 8p (44%), 1q (36%), and 3p (33%) of SCC. Oncogene amplifications included broad 3q alterations affecting TP63, SOX2, PIK3CA (43%) and 8q including MYC, HEY, RAD21 (40%). Homozygous deletions affected WRN, NRG1 (8p;29%), BAP1, FANCD2, VHL (3p) and ARHGEF12, BCL9L, ATM (11q22/23) in 19% each. CNA affecting TP53, CDKN2A/B, CDKN1A/B, and RB1 occurred in similar numbers in HPV-induced (16%) and HPV-independent SCC (24%) quite in contrast to TSG somatic mutations exclusive to HPV-independent SCC associated with lichenoid dermatoses. HPV-induced SCC had more 1p amplifications (adj. p=.003), while HPV-independent SCC carried more 8q full-arm gains (adj. p=.00003), amplifications of oncogenes on 8q (adj. p=.006) including MYC and homozygous deletions of 8p (adj. p=.03). MYC amplifications coincided with an increased fraction of genome altered indicative for genomic instability (p=.00001). EGFR amplifications dominated in HPV-negative wild-type TP53/CDKN2A SCC without dermatoses. Together with mutations in PIK3CA, HRAS and FGFR3 they represent an alternative RTK/Ras/PI3K-mediated carcinogenesis pathway. More than half of advanced SCC irrespective of etiology harbored targetable CNA such as EGFR, MTAP, ATM.
Keywords:
penile squamous cell carcinoma
copy-number alterations
human papillomavirus
oncogenes
tumor suppressor genes
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Laboratory Investigation cover
Laboratory Investigation
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4.2
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