Abstract
Epstein-Barr virus (EBV) is a ubiquitous herpesvirus, and most people have serological evidence of previous viral infection at adult age. EBV is associated with infectious mononucleosis and human cancers, including some lymphomas and gastric carcinomas. Although EBV was first reported in lymphoepithelioma-like gastric carcinoma, the virus was also found in conventional adenocarcinomas. In the present study, 53 gastric carcinomas diagnosed in São Paulo State, Brazil, were evaluated for EBV infection by non-isotopic in situ hybridization with a biotinylated probe (Biotin-AGACACCGTCCTCACCACCC GGGACTTGTA) directed to the viral transcript EBER-I, which is actively expressed in EBV latently infected cells. EBV infection was found in 6 of 53 (11.32%) gastric carcinomas, mostly from male patients (66.7%), with a mean age of 59 years old. Most EBV-positive tumors were in gastric antrum. Two EBV-positive tumors (33.3%) were conventional adenocarcinomas, whereas four (66.7%) were classified as lymphoepithelioma-like carcinomas. EBV infection in gastric carcinomas was reported elsewhere in frequencies that range from 5.6% (Korea) up to 18% (Germany). In Brazil, a previous work found EBV infection in 4 of 80 (5%) gastric carcinomas, whereas another study found 4.7 and 11.2% of EBV-positive gastric carcinomas of Brazilians of Japanese origin or not, respectively. In the present study, the frequency of EBV-positive gastric carcinomas is similar to that reported in other series, and the clinicopathologic characteristics of these EBV-positive tumors are in agreement with the data in the literature.
Highlights
The aim of the present study was to provide additional information about the prevalence and characteristics of Epstein-Barr virus (EBV) infection in gastric carcinomas diagnosed in São Paulo State, Brazil, and compare the results with other series of EBV-positive gastric cancer elsewhere
The undifferentiated and lymphoepithelioma-like types of carcinoma were considered for classification, and the criteria for diagnosis of lymphoepithelioma-like carcinomas (LELC) were applied as described by Watanabe et al [22]
According to the anatomical site of the gastric carcinoma, 22 (41.5%) carcinomas were present in the antrum, 6 (11.3%) in the middle portion of the stomach, and 5 (9.4%) in the cardia
Summary
In the 1990s, some papers reported the association between gastric carcinoma and EBV infection. LELC is an uncommon type of gastric carcinoma [17,19,22] strongly associated with EBV, with this association ranging from 77.8 to 87.5% of cases [17,19,20,21]. Several investigators subsequently added new information regarding the prevalence and clinicopathologic characteristics of EBV infection in gastric carcinomas of different populations from North, Central and South America, Europe and Asia; there are few reports concerning clinicopathologic data of EBV-related gastric carcinomas among Brazilians, including one study that compares characteristics of EBV-positive gastric carcinomas from Brazilians of Japanese origin or not [23]
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