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. 2011 Jun 28;105(1):38-43.
doi: 10.1038/bjc.2011.215. Epub 2011 Jun 7.

Determinants of Epstein-Barr virus-positive gastric cancer: an international pooled analysis

M C Camargo  1 , G Murphy, C Koriyama, R M Pfeiffer, W H Kim, R Herrera-Goepfert, A H Corvalan, E Carrascal, A Abdirad, M Anwar, Z Hao, J Kattoor, E Yoshiwara-Wakabayashi, Y Eizuru, C S Rabkin, S Akiba
Affiliations

Determinants of Epstein-Barr virus-positive gastric cancer: an international pooled analysis

M C Camargo et al. Br J Cancer. .

Abstract

Background: Meta-analyses of the published literature indicate that about 9% of gastric cancers contain Epstein-Barr virus (EBV), with consistent and significant differences by sex and anatomic subsite. This study aimed to identify additional determinants of EBV positivity and their joint effects.

Methods: From 15 international populations with consistent laboratory testing for EBV, we pooled individual-level data for 5081 gastric cancer cases including information on age, sex, subsite, histologic type, diagnostic stage, geographic region, and period of diagnosis. First, we combined population-specific EBV prevalence estimates using random effects meta-analysis. We then aggregated individual-level data to estimate odds ratios of EBV positivity in relation to all variables, accounting for within-population clustering.

Results: In unadjusted analyses, EBV positivity was significantly higher in males, young subjects, non-antral subsites, diffuse-type histology, and in studies from the Americas. Multivariable analyses confirmed significant associations with histology and region. Sex interacted with age (P=0.003) and subsite (P=0.002) such that male predominance decreased with age for both subsites. The positivity of EBV was not significantly associated with either stage or time period.

Conclusion: Aggregating individual-level data provides additional information over meta-analyses. Distinguishing histologic and geographic features as well as interactions among age, sex, and subsite further support classification of EBV-associated gastric cancer as a distinct aetiologic entity.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Estimated prevalence (95% CIs) of EBV positivity in gastric cancers from 15 populations.
Figure 2
Figure 2
Fitted age-specific prevalence of EBV positivity in gastric tumours, by sex and anatomic subsite.
See this image and copyright information in PMC

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