Abstract

BackgroundThe oncogenic potential of Epstein-Barr virus (EBV) in breast cancer is being increasingly recognized. Despite some controversies regarding such role, new evidence is suggesting a culpability of EBV in breast cancer, particularly in Africa where the virus has been originally associated with causation of several solid and hematological malignancies. One example is a report from Sudan implicating EBV as a prime etiologic agent for an aggressive type of breast cancer, where nearly 100% of tumor tissues were shown to carry viral signatures. To get a broader view on such association, other nearby countries should be investigated. The present study aims to determine the prevalence and possible associations of the virus in Eritrean breast cancer patients.MethodsDetection of EBV genome using primers that target Epstein Barr Encoded RNA (EBER) gene and Latent Membrane Protein-1 (LMP-1) gene sequences was performed by polymerase chain reaction (PCR) on DNA samples extracted from 144 formalin fixed paraffin embedded breast cancer tissues and 63 non-cancerous breast tissue as control group. A subset of PCR positive samples was evaluated for EBER gene expression by in situ hybridization (ISH). Expression of Latent Membrane Protein-2a (LMP2a) was also assessed by immunohistochemistry in a subset of 45 samples.ResultsBased on PCR results, EBV genome signals were detected in a total of 40 samples (27.77%) as compared to controls (p-value = 0. 0031) with a higher sensitivity when using the EBER primers. Five out of the 14 samples stained by EBER-ISH 35.71% were positive for the virus indicating the presence of the viral genome within the tumor cells. Of those stained for IHC 7 (15.55%) were positive for LMP2a showing low viral protein frequency.ConclusionsBased on these findings it can be concluded that EBV in Eritrea is associated with a smaller subset of tumors, unlike neighboring Sudan, thus pointing to possible differences in population predisposition and diseases epidemiology.

Highlights

  • The oncogenic potential of Epstein-Barr virus (EBV) in breast cancer is being increasingly recognized

  • Patients and tissues This study comprises formalin fixed paraffin- embedded (FFPE) cancer biopsies from 144 cases of breast carcinoma retrieved from the Department of Histopathology, National Health Laboratory, Ministry of Health, Eritrea during 2013, 2014

  • Molecular detection of EBV in breast cancer cases DNA was successfully extracted from 144 FFPE samples of breast carcinoma patients, and from 63 non- cancerous benign tissues samples

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Summary

Introduction

The oncogenic potential of Epstein-Barr virus (EBV) in breast cancer is being increasingly recognized. Despite some controversies regarding such role, new evidence is suggesting a culpability of EBV in breast cancer, in Africa where the virus has been originally associated with causation of several solid and hematological malignancies. One example is a report from Sudan implicating EBV as a prime etiologic agent for an aggressive type of breast cancer, where nearly 100% of tumor tissues were shown to carry viral signatures. The present study aims to determine the prevalence and possible associations of the virus in Eritrean breast cancer patients. Breast cancer is the most common form of malignancy in women both in developed and the developing countries [1]. Some authors believe that EBV may play a role in breast cancer oncogenesis not as a primary etiological agent but acts in concert with other cofactors [29]. A meta-analysis study concluded that EBV acts as a cofactor in breast cancer development [30]

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