E-cadherin expression in male urethral smears and correlation with PCR-based detection of human papillomavirus...

We performed cytological examination of urethral brushing to study aberrant E-Cadherin expression as a possible marker for papillomavirus in cytological samples. A total of 30 cytobrush male urethral smears were examined E-cadherin expression and human papillomavirus (hpv) was confirmed using PCR-DNA. The age range was 19-36 years (mean: 27 years), 17 (56.7%) cases corresponded to low-risk HPV and 13 (43.3%) cases were high-risk HPV. The mean age ranges were 25.77 +/- 5.90 years for high-risk HPV and 26.77 +/- 4.31 years for low-risk HPV. Pap smears showed dyskeratosis in 23 (76.7%) cases, koilocytes in 13 (43.3%) cases, infection or bacterial background in 14 (43.7%) cases, suggestive changes of Gardnerella infection in 7 (23.3%) cases, and Chlamydia in 3 (10%) cases. Immunohistochemistry was positive for membrane E-Cadherin; there was weak expression in 13 (43.3%) cases, moderate expression in 11 (36.7%) cases (P = 0.109) (Figs. 3a and b), and strong expression in 6 (20%) cases. There were a statistically significant correlations between E-Cadherin expression and koilocytes (P = 0.007), individual cell dyskeratosis (P = 0.041), and HPV risk (P = 0.000). We concluded that the loss of E-Cadherin membrane expression was greater in high-risk HPV cases and was associated with individual cell dyskeratosis features and koilocytes. There were statistically significant correlations between E-Cadherin expression and dyskeratosis (P = 0.043), koilocytes (P = 0.007), and type of HPV (P = 0.000). Using male urethral smears to test for the loss of E-Cadherin membrane expression is simple, rapid, specific and more sensitive than conventional morphologic observations. We concluded that E-Cadherin can be used to discriminate between high- and low-risk papillomavirus in urethral cytologic specimens.