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Histopathological Features and p16/p62 Expression as Indicators of High-Risk HPV Co-Infection in Anogenital Condyloma
Hermin Aminah Usman1, Etis Primastari1, Pati Aji Achdiat2
1Department of Anatomic Pathology, Faculty of Medicine, Universitas Padjadjaran-Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia.
Background:
Condyloma acuminata (CA) is primarily caused by low-risk human papillomavirus (LR-HPV); however, high-risk HPV (HR-HPV) co-infection is increasingly reported and cannot be reliably distinguished based on clinical appearance alone. Histopathological assessment and selected immunohistochemical markers may help identify lesions with greater biological risk.
Objective:
To evaluate the association between histopathological features, p16 and p62 expression, and HR-HPV co-infection in anogenital CA.
Methods:
This cross-sectional study included 81 histopathologically confirmed CA cases. Semi-quantitative scoring was applied to lesion morphology, keratinization patterns, koilocytosis, atypical mitoses, and lymphocytic infiltration. p16 and p62 expression were assessed immunohistochemically. HPV genotyping was performed using real-time PCR. Variables significant in bivariate analysis were entered into multivariate logistic regression.
Results:
HR-HPV co-infection was detected in 59.3% of cases, with HPV-16 as the most frequent genotype. Hyperkeratosis (aOR = 4.29; p = 0.039) and atypical mitotic activity (aOR = 14.29; p < 0.001) were independently associated with HR-HPV co-infection. Parakeratosis and koilocytosis showed inverse associations. p16 and p62 were not independent predictors, although p16 block positivity correlated with high p62 expression (p < 0.001).
Conclusion:
Certain histopathological features, particularly atypical mitoses and hyperkeratosis, are associated with HR-HPV co-infection in anogenital CA. Routine histopathological evaluation may therefore provide practical clues to identify lesions that warrant closer clinical attention, while p16 and p62 offer complementary biological information.
