提供有关阴茎上皮内瘤变 (PeIN) 的现有数据的概述，以及对咪喹莫特（IQ；Toll 样受体 7 激动剂）治疗和可预测治疗反应的免疫微环境标志物的叙述性综述。叙述性综述在 PubMed 上对 2000 年至今的文献进行了检索，我们描述了最相关的数据和交叉引用。PeIN 的发病率正在增加。 IQ 局部治疗可能提供一种易于应用的治疗方法，完全缓解率高达 63%，但可能会带来相当大的副作用。 PeIN 的最佳治疗方案尚无确凿数据，但对其他人乳头瘤病毒相关癌前病变的治疗结果评估表明每周 3 次，持续时间长达 16 周。目前尚未发表有关 PeIN 免疫微环境的研究。然而，关于阴茎癌和癌前外阴和宫颈病变的少数研究结果表明，特定的免疫细胞亚群可以作为未来成功免疫调节治疗（如 IQ）的预测因子。总体而言，关于 PeIN IQ 治疗的可用数据有限，并且没有已发表的数据存在于 PeIN 免疫微环境中。需要进一步的转化研究，以更好地了解 PeIN 的病理生理学以及进展和局部治疗反应的潜在预测因子。© 2024 BJU International。

To provide an outline of the existing data on penile intraepithelial neoplasia (PeIN), as well as a narrative review on imiquimod (IQ; a toll-like receptor 7 agonist) treatment and immune microenvironment markers that may predict response to treatment.A narrative review of the literature from 2000 to the present was conducted on PubMed, and we describe the most relevant data and cross references.The incidence of PeIN is increasing. Local therapy with IQ may offer an easy applicable treatment with complete response rates of up to 63% but can be associated with considerable side-effects. There is no conclusive data on the optimal treatment schedule for PeIN, but evaluation of treatment results for other human papillomavirus-related pre-malignancies suggest three times a week for a duration up to 16 weeks. There are no published studies concerning the PeIN immune microenvironment. However, findings from the few studies on penile cancer and pre-cancerous vulvar and cervical lesions imply that specific immune cell subpopulations can serve as future predictors for successful immunomodulation treatments such as IQ.Overall, limited data are available on IQ treatment for PeIN and no published data exists on the PeIN immune microenvironment. Further translational studies are warranted to gain more understanding on the pathophysiology of PeIN and potential predictors of progression and of response to topical treatments.© 2024 BJU International.