Abstract
Epstein–Barr virus (EBV) is a ubiquitous human herpes virus, but related with several types of malignancies. Among EBV-related malignancies, EBV-associated gastric carcinoma (EBVaGC) has the largest patient’s number. We screened for EBV infection in 1067 GC lesions of 1132 patients who underwent surgical resection from 2007 to 2017 in Japan and examined clinicopathological features of EBVaGC. EBV infection was detected by in situ hybridization with EBV-encoded small RNA 1(EBER-1 ISH). EBV was infected in 80 GC lesions (7.1%). Mean age was significantly lower in patients with EBVaGC than with EBV-negative GC. EBVaGC was more frequent in men than in women. EBVaGC was found twice as frequent in the upper or middle stomach as in the lower stomach. Early EBVaGC was more frequent, and submucosally invaded cases were dominant. The presence of lymphatic vessel invasion was less in EBVaGC, but frequency of lymph node metastasis was similar. Carcinoma with lymphoid stroma (CLS) was found in 3.8% (43/1132) of all lesions with 60.5% of EBV positivity. The synchronous or metachronous multiple GC was frequent in EBVaGC. We clarified clinicopathologic characteristics of EBVaGC over the past decade in Japan. EBV infection should be examined in gastric cancer cases showing these characteristics.
Highlights
Epstein–Barr virus (EBV) is a ubiquitous human herpes virus discovered from a Burkitt lymphoma cell
Carcinoma with lymphoid stroma (CLS), which is considered to be a pathological feature of EBV-associated gastric carcinoma (EBVaGC), was classified separately
The macroscopic types of the gastric carcinoma (GC) were classified according to the Japanese Classification of Gastric Carcinoma [14]
Summary
Epstein–Barr virus (EBV) is a ubiquitous human herpes virus discovered from a Burkitt lymphoma cell. EBV is associated with a variety of tumors derived from B cells, such as Burkitt lymphoma, post-transplant lymphoproliferative disease, and Hodgkin’s disease. EBV is detected from epithelial tumors, including nasopharyngeal carcinoma and gastric carcinoma (GC). The virus is sometimes associated with peripheral T-cell lymphomas and nasal natural killer T-cell lymphomas [1,2]. Gastric cancer is the fifth frequently diagnosed cancer and the third leading cause of cancer deaths worldwide [3]. EBV-associated GC (EBVaGC) is about 10% of all GC worldwide [4,5]. EBVaGC is not endemic like EBV-related Burkitt lymphoma and nasopharyngeal carcinoma. Among EBV-related malignancies, EBVaGC is the most common. EBVaGC has not received clinical attention because there is no specific treatment for this malignancy
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