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Etwa die H\u00e4lfte der Peniskarzinome entsteht \u00fcber die Pr\u00e4kanzerose hochgradige squam\u00f6se intraepitheliale L\u00e4sion (HSIL) durch eine transformierende Infektion mit humanen Papillomaviren (HPV)\u00a0\u2013 am h\u00e4ufigsten High-risk-HPV\u00a016. Die HP-E6\/E7-Onkogenproteine binden an Proteine der p53 und Retinoblastomsignalwege. Diese Zellzyklusst\u00f6rung f\u00fchrt zur zellul\u00e4ren Ansammlung\/\u00dcberexpression von p16, was als Biomarker f\u00fcr HPV-assoziierte Karzinogenese gilt. Die Mehrheit der HPV-unabh\u00e4ngigen Peniskarzinome entsteht in L\u00e4sionen chronischer lichenoider Dermatosen (Lichen sclerosus und Lichen planus) \u00fcber die schnell fortschreitende Pr\u00e4kanzerose differenzierte penile intraepitheliale Neoplasie (dPeIN). Diese entz\u00fcndungsassoziierten, meist hoch differenzierten verhornten Karzinome enthalten Mutationen in Tumorsuppressorgenen\n                    <jats:italic>CDKN2A<\/jats:italic>\n                    und\n                    <jats:italic>TP53<\/jats:italic>\n                    . Missense-TP53-Mutationen f\u00fchren zur Ansammlung von aberrantem p53-Protein in Kernen proliferierender Tumorzellen (nukle\u00e4re \u00dcberexpression). Die restlichen HPV-negativen, \u00fcberwiegend verruk\u00f6sen Peniskarzinome entstehen ohne Dermatosen und Tumorsuppressorgenmutationen und sind ohne p16- und p53-\u00dcberexpression. Sie entwickeln sich \u00fcber verruk\u00f6se PeIN. Die korrekte \u00e4tiologische Zuordnung hat klinische Bedeutung, denn HPV-assoziierte Peniskarzinome haben eine bessere Prognose und \u00dcberlebensraten. Sie ist insbesondere wichtig f\u00fcr die Wahl der Therapie der Pr\u00e4kanzerosen. Die langsam fortscheitende HSIL kann chirurgisch, destruktiv oder medikament\u00f6s \u00fcber einen l\u00e4ngeren Zeitraum behandelt werden. dPeIN dagegen sollte zeitnah chirurgisch saniert werden, um eine fr\u00fche Invasion auszuschlie\u00dfen. Leitliniengerechte Therapie der Dermatosen kann das Karzinomrisiko reduzieren.\n                  <\/jats:p>","DOI":"10.1007\/s00120-025-02701-7","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T16:38:40Z","timestamp":1761151120000},"page":"1254-1260","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Update zur Pathologie der Peniskarzinome","Update on the pathologic features of penile cancer"],"prefix":"10.1007","volume":"64","author":[{"given":"Sigrid","family":"Regauer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,10,22]]},"reference":[{"key":"2701_CR1","first-page":"372","volume-title":"HPV-associated squamous cell carcinoma, in WHO Classification of Tumors. 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