Comparative analysis of human papillomavirus detection in tissue and urinary/plasmatic exosomes in prostatic...

The etiological role of human papillomavirus (HPV) in prostate carcinogenesis remains controversial, despite its well-established causal association with cervical and oropharyngeal cancers. Exosomes, recognized as key mediators of intercellular communication, are increasingly implicated in viral dissemination and tumor progression, and have been proposed as minimally invasive diagnostic tools. In this study, we investigated the prevalence of HPV DNA in prostate tissue, plasma-derived exosomes, and urine-derived exosomes, and examined its correlation with clinicopathological parameters in patients with histologically confirmed prostate cancer. Fifty patients were prospectively included. HPV DNA was detected in 32% of prostate tissue samples, 24% of plasma-derived exosomes, and 28% of urine-derived exosomes. Statistically significant associations were observed between HPV positivity and higher Gleason scores (p = 0.017), advanced T stage (p = 0.003), and alcohol consumption (p = 0.035). In contrast, only 2% of control samples were HPV DNA positive. Notably, detection of HPV DNA in exosomal fractions mirrored tissue-based positivity, highlighting the potential of exosome-based liquid biopsies as noninvasive diagnostic approaches. While our findings support a possible association between HPV and prostate cancer, causality remains unresolved. Nevertheless, the study underscores the promise of exosome-based detection methods for future applications in noninvasive diagnosis, disease monitoring, and development of targeted therapeutic strategies-approaches that are already clinically relevant in HPV-driven cancers such as cervical cancer.