Abstract
Background: Penile cancer is a rare cancer in the world. Targeted immunotherapy using Granzyme B (GrB) is now considered to be one candidate of potent treatment modalities for solid cancer. This serine protease enzyme is usually produced by Cytotoxic T Lymphocytes (CTL) and Natural Killer (NK) cells, the components of Tumor-Infiltrating Lymphocytes (TIL). This study aims to determine the degree of TIL and GrB expression in penile cancer.

Methods: This is a cross-sectional design involving 42 penile cancer patients in Sanglah Hospital, Bali, between 2011-2016. Data obtain include age, histological parameters, and GrB expression. Histological parameters were examined from Hematoxylline Eosin slides. GrB expression was determined using the immunohistochemical method. Data collected were analyzed with the chi-square test.

Results: The study shows the age range was 29-82 years old. The number of cases was nearly equal between ï‚£50 and >50 years old groups (47.6 vs. 52.4%). Most patients had non HPV related subtypes (71.4%), high pT stage (66.7%), negative LVI (76.2%) and moderate until marked TIL (50% and 38.1%, respectively). The degree of TIL and level of GrB expression in mild and moderate TIL have a low level of GrB expression. In contrast, marked TIL mostly has a high level of GrB expression.

Conclusion: Most penile cancer has moderate and marked TIL. This marked TIL tends to show a high level of GrB expression. However, no correlation found between TIL and GrB with age and histologic parameters. Further study is needed to have more evidence about the potential role of GrB in penile cancer therapy.

Key words: Tumor-Infiltrating Lymphocytes, Granzyme B, Penile Squamous Cell Carcinoma